Clinical and Experimental Study of Modified Proximal and Distal Tibial Osteotomy and Transposition for Diabetic Foot
Objective:To compare the clinical efficacy of modified proximal and distal tibial osteotomy and modified simple proximal tibial osteotomy on the treatment of Wagner 3/4 grade diabetic foot.Methods:40 patients with Wagner 3/4 grade diabetic foot from January 2021 to January 2023 were randomly included in the observation group(general treatment and modified proximal and distal tibial osteotomy and transfer)and the control group(general treatment and modified simple proximal osteotomy and transfer)with 20 cases in each group.The Michigan neuropathy screening instrument(MNSI)scores,visual analogue scale(VAS)scores,ankle-brachial index(ABI),percutaneous oxygen partial pressure,and ankle skin temperature of two groups of patients after corresponding treatment were recorded.Among them,there were 12 males and 8 females in the observation group;the age ranged from 59 to 88 years old,with an average of(72.6±6.4)years old.Body mass index(BMI)ranged from 22 to 35 kg/m2,with an average of(23.4±2.1)kg/m2.The preoperative skin temperature of the foot dorsum were(27.50±1.08)℃,the VAS scores of pain were(7.40±0.36)points,the ABI were 0.27±0.47,and the transcutaneous partial pressure of oxygen were(28.4±2.14)mmHg.There were 11 males and 9 females in the control group,aged frome 55 to 85 years old,with an average of(76.2±6.9)years old and a body mass index of 22-36 kg/m2,with an average of(25.8±1.7)kg/m2.Preoperative skin temperature of the foot dorsum were(28.10±1.02)℃,VAS scores were(6.80±0.33)points,ABI were 0.30±0.64,and transcutaneous partial oxygen pressure were(27.90±2.01)mmHg.There was no statistically significant difference in preoperative baseline and clinical data between the two groups of patients.Results:The MNSI scores of ABI,percutaneous partial pressure of oxygen and skin temperature of foot and ankle in the observation group were higher than those in the control group,the VAS scores were lower than that of the control group(P＜0.05).Conclu-sion:The clinical efficacy of modified proximal and distal tibial osteotomy on the treatment of Wagner 3/4 grade diabetic foot is better than that of modified simple proximal osteotomy,which can promote the recovery of peripheral blood vessels and peripheral nerves faster than that of modified simple proximal osteotomy.The success rate of limb salvage on the treatment of Wagner 3/4 grade severe diabetic foot is high,and it is one of the ideal methods for the treatment of severe diabetic foot ulcers.
proximal and distal tibiaosteotomy and removaldiabetic foot
万方数据
维普
