关键词: 糖尿病足溃疡； Wagner 3~4级； 改良胫骨横向骨搬运技术； 负压封闭引流； 创面愈合

Abstract: Objective To explore the clinical curative effect of modified transverse tibial bone transport in Wagner grade 3-4 diabetic foot ulcer (DFU).Methods A total of 146 patients with Wagner grade 3-4 DFU admitted to the Beijing Longfu Hospital were enrolled From March 2016 to December 2025.According to random number table method, they were divided into observation group and control group, 73 cases in each group.On basis of systemic basic treatment, control group was treated with traditional transverse tibial bone transport, while observation group was treated with modified transverse tibial bone transport.The pain degree [visual analogue scale (VAS)], ankle-brachial index (ABI), foot skin temperature and transcutaneous oxygen pressure (TcPO2) were compared between the two groups before treatment, at 1 month and 3 months after treatment.The ulcer healing time and ulcer area were recorded to evaluate safety.All were followed up for 1 year to observe incidence of major amputation.Results The ulcer area and ulcer healing time in observation group were (2.25±0.58) cm2 and (64.95±3.52) d, smaller (shorter) than those in control group [(3.17±0.82) cm2, (71.24±4.89) d, P<0.05].At 1 month and 3 months after treatment, VAS scores in observation group were (3.07±1.86) points and (1.18±0.31) points, VAS scores in control group were (4.04±1.12) points and (2.29±0.51) points; ABI in observation group were (0.70±0.19) and (0.95±0.23), ABI in control group were (0.56±0.13) and (0.81±0.20); foot skin temperature in observation group were (31.54±1.16)℃ and (33.17±1.62)℃, foot skin temperature in control group were (29.32±1.08)℃ and (30.51±1.24)℃, TcPO2 in observation group were (30.55±2.71) mm Hg and (34.92±3.05) mm Hg, TcPO2 in control group were(29.13±2.52) mm Hg and (31.80±2.73) mm Hg, the differences between two groups were all statistically significant (P<0.05).The incidence of complications in observation group was lower than that in control group (6.85% vs 17.81%, P<0.05).There was no difference in amputation rate between two groups (P=0.497).Conclusion The modified transverse tibial bone transport can promote fast healing of ulcer wound, relieve pain, improve foot temperature and blood supply of affected limbs, and reduce incidence of complications in patients with Wagner grade 3-4 DFU.

Key words: diabetic foot ulcer; Wagner grade 3-4; modified transverse tibial bone transport; vacuum sealing drainage; wound healing