[Medium- and long-term clinical efficacy of tibial transverse transport surgery in the treatment of diabetic foot ulcers].

Ankle brachial index (ABI) of affected feet significantly improved after TTT surgery and remained elevated through 3 years of follow-up.

• Preoperative ABI was 0.55 (0.47, 0.62).
• ABI values at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years after surgery were 0.70 (0.65, 0.76), 0.93 (0.83, 1.01), 0.96 (0.86, 1.06), 0.93 (0.88, 1.01), 0.91 (0.86, 0.97), and 0.90 (0.81, 0.97), respectively.
• All postoperative ABI values were significantly higher than preoperative values (P<0.05).
• Peak improvement occurred at 6 months postoperatively, with sustained elevation maintained through 3 years.

The 10 g monofilament test point count of affected feet was significantly greater at all postoperative time points compared to preoperatively.

• Assessments were made before surgery and at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years after surgery.
• All postoperative values were significantly higher than preoperative values (P<0.05).
• This finding indicates improved peripheral sensation and nerve conduction function in the affected feet.
• The improvement was sustained through the full 3-year follow-up period.

VAS pain scores of affected feet were significantly reduced at all postoperative time points compared to preoperatively.

• Assessments were conducted before surgery and at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years after surgery.
• All postoperative VAS scores were significantly lower than preoperative scores (P<0.05).
• Pain reduction was maintained across the entire 3-year follow-up period.

MNSI physical examination scores of affected feet were significantly reduced at all postoperative time points compared to preoperatively.

• The Michigan Neuropathy Screening Instrument (MNSI) physical examination score was used to assess neuropathy.
• All postoperative MNSI scores were significantly lower than preoperative scores (P<0.05).
• Improvement was sustained through the entire 3-year follow-up period.
• Lower MNSI scores indicate improvement in neuropathic symptoms.

Toe oxygen saturation of affected feet was significantly higher at all postoperative time points compared to preoperatively.

• Assessments were made before surgery and at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years after surgery.
• All postoperative toe oxygen saturation levels were significantly higher than preoperative levels (P<0.05).
• Sustained improvement through 3 years indicates durable enhancement of foot microcirculation.

Within 3 years after TTT surgery, wound healing was achieved in 80 of 87 patients, and 7 patients required amputation.

• The study enrolled 87 patients with DFU treated with TTT surgery.
• 80 patients achieved wound healing within 3 years postoperatively.
• 7 patients underwent amputation within 3 years postoperatively.
• Patient numbers available at follow-up time points decreased due to amputation, death, or loss to follow-up: 85 at 3 months, 82 at 6 months, 77 at 1 year, 73 at 2 years, and 63 at 3 years.

Postoperative complications following TTT surgery were infrequent, and all resolved with conservative treatment.

• Within 3 years after surgery, 3 patients experienced fractures at the bone transport site.
• 4 patients developed infections at the pin tract and incision.
• All 7 patients with complications (fractures or infections) recovered with conservative treatment.
• No complications required further surgical intervention.

The study population consisted of 87 DFU patients treated with TTT surgery at a single center over a 7-year period.

• Patients were admitted to the Department of Orthopedics of Shanxi Provincial People's Hospital from January 2015 to December 2022.
• There were 70 males and 17 females with a mean age of (59±11) years.
• This was a retrospective cohort study design.
• Patients were followed for up to 3 years postoperatively with assessments at 1 month, 3 months, 6 months, 1 year, 2 years, and 3 years.