胫骨横向骨搬移技术治疗糖尿病足的专家共识(2020)  

Expert consensus on the treatment of diabetic foot ulcers using tibial transverse transport(2020)

作　　者：无 赵劲民[2,3,4,5,6,7] 李刚 

机构地区：[1]中国医师协会骨科医师分会中国骨搬移糖尿病足学组 [2]广西医科大学 [3]中国医师协会骨科医师分会 [4]中国医师协会住院医师规范化培训骨科专业委员会 [5]亚太重建显微外科联盟中国部 [6]广西医师协会 [7]广西医学会骨科学分会 [8]香港中文大学医学院矫形外科及创伤学系 [9]国际外固定与肢体重建学会(ILLRS)中国区 [10]中国骨科医师协会肢体矫形与重建委员会

出　　处：《中国修复重建外科杂志》2020年第8期945-950,共6页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：四川省卫生健康委员会科研课题(19PJ056)。

摘　　要：胫骨横向骨搬移(tibial transverse transport,TTT)技术源自俄罗斯医学专家Ilizarov创立的肢体再生与功能重建理论。在张力-应力法则作用下,组织再生能力被激活、加强,通过给予一定应力性牵拉,骨骼及其附着的肌肉、筋膜、血管、神经会同步生长。虽然Ilizarov医生发现了牵拉成骨过程中血管网新生的现象,但未将该技术深入应用于微循环重建的领域。中国骨科医师在世界上首先将TTT技术用于治疗下肢血管性病变及糖尿病足,研究结果初步显示该技术可诱导糖尿病足下肢微血管网再生,促进足部溃疡愈合、避免截肢,降低糖尿病足的整体风险。为进一步促进TTT技术在糖尿病足治疗中的应用,中国医师协会骨科医师分会中国骨搬移糖尿病足学组组织专家编撰了专家共识,对TTT技术的适应证、禁忌证、手术方法以及围术期管理等提出了明确建议。Ilizarov first reported the tibial transverse transport(TTT)for limb regeneration and functional reconstruction.The law of tension-stress could activate and enhance the regenerative potentials of living tissues,leading to growth or regeneration of muscles,fascia,blood vessels,and nerves simultaneously.Ilizarov discovered the phenomenon of rich vascular network formation during distraction osteogenesis process,but he did not apply this technique purposely to reconstruct microcirculation.Chinese orthopedic surgeons first used the TTT to treat lower extremity vascular lesions and diabetic foot ulcers.At present,some small sample clinical studies showed that the TTT could reconstruct microvascular network in the lower limbs of diabetic foot and promote the healing of foot ulcers.The use of TTT could significantly reduce the overall risk of diabetic foot complication especially the amputation risk.This expert consensus is initiated by the Chinese Association of Orthopaedic Surgeons(CAOS),Taskforce Group of Tibial Cortex Transverse Transport Technique for the Treatment of Diabetic Foot Ulcers.This expert consensus provides clear recommendations for indications,contraindications,principles for surgical procedures,preoperative and postoperative management,which maximize the success rate for TTT surgery in treatment of severe diabetic foot ulcers.

关 键 词：胫骨横向骨搬移技术 糖尿病足 专家共识 

分 类 号：R687.3[医药卫生—骨科学]