Clinical Study of Modified Tibial Transverse Transport Combined with the Masquelet Technique for the Treatment of Diabetic Foot with Ulcers.

Diabetic foot ulcers are a serious complication of diabetes that can lead to amputation if not treated effectively. For patients who do not respond to standard care, such as cleaning the wound and using antibiotics, new surgical options are being explored. In this study, researchers tested a combination of two techniques: moving a small piece of bone from the shin to improve blood flow (tibial transverse transport) and using a two-stage procedure to fill bone gaps (Masquelet technique). The study included 46 patients with moderate-to-severe ulcers (Wagner stages 2-4), half of whom received the new combined surgery and half received standard treatment. Results showed that the surgery group had a higher rate of complete wound healing, with 87% of patients achieving full closure compared to 52% in the standard care group. Additionally, the surgery group had a shorter time to healing (around 2.5 months versus 4 months) and a lower rate of ulcer recurrence at 6 months. Importantly, limb salvage was achieved in all surgery patients, whereas two patients in the standard group required amputation. These findings suggest that this combined surgical approach could significantly benefit patients with stubborn diabetic foot ulcers, but more research is needed to confirm the long-term outcomes and the best candidates for this surgery.