Biological mechanisms of tibial transverse transport for promoting microcirculation and tissue repair_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YANG Yongkang ,  LI Gang

Department of Orthopaedics & Traumatology, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, P.R.China;

Corresponding author：

LI Gang, Email: gangli@cuhk.edu.hk

Keywords：

Tibial transverse transport; microcirculation; tissue repair; biological mechanism

DOI：

10.7507/1002-1892.202003042

Video：

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Objective To explore the biological mechanisms of tibial transverse transport (TTT) for promoting microcirculation and tissue repair.Methods The clinical application and animal model study of TTT were reviewed.Results The possible biological mechanisms of TTT for promoting microvascular network formation and tissue repair: ① Tibial corticotomy reduces intramedullary pressure and improves microcirculation; ② Tension stress stimulation promotes microvascular regeneration and accelerates the formation of new “transcortical vessels” network; ③ Systemic mobilization of stem cells, mediating local inflammation, etc.Conclusion TTT has been clinically proven to be effective for the management of lower limb ischemia and diabetic foot ulcers. The surgical procedure is relatively easy with little adverse effects on bone structures. The TTT has good application prospects despite the biological mechanisms of which still need further exploration.

Citation： YANG Yongkang, LI Gang. Biological mechanisms of tibial transverse transport for promoting microcirculation and tissue repair. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(8): 964-968. doi: 10.7507/1002-1892.202003042 Copy

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3.	花奇凯, 王林, 冼呈, 等. Ilizarov 胫骨横向骨搬移微循环重建技术治疗下肢慢性缺血性疾病的临床疗效. 中国矫形外科杂志, 2015, 23(21): 2007-2011.
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8.	Chen Y, Kuang X, Zhou J, et al. Proximal tibial cortex transverse distraction facilitating healing and limb salvage in severe and recalcitrant diabetic foot ulcers. Clin Orthop Relat Res, 2020, 478(4): 836-851.
9.	田浩明, 李舍予. 长期血糖控制与糖尿病慢性血管并发症: 循证治疗三十年. 中华糖尿病杂志, 2016, 8(11): 641-644.
10.	中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南 (2019 版) (Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
11.	Li G, Simpson AH, Kenwright J, et al. Effect of lengthening rate on angiogenesis during distraction osteogenesis. J Orthop Res, 1999, 17(3): 362-367.
12.	Xu J, Sun Y, Wu T, et al. Enhancement of bone regeneration with the accordion technique via HIF-1α/VEGF activation in a rat distraction osteogenesis model. J Tissue Eng Regen Med, 2018, 12(2): e1268-e1276.
13.	连浩宇. 干细胞动员在胫骨横向搬移治疗重度糖尿病足机制中的作用研究. 南宁: 广西医科大学, 2019.
14.	高伟. 重度糖尿病足横向骨搬移疗效与创面再生机制中巨噬细胞及表皮干细胞作用研究. 南宁: 广西医科大学, 2018.
15.	项杰. 胫骨横向骨搬移对糖尿病足患者造血干细胞集落形成及 PI3K/AKT 信号通路的影响. 南宁: 广西医科大学, 2018.
16.	镇普祥, 陈炎, 高伟, 等. 应用 Ilizarov 技术胫骨横向骨搬移术治疗合并全身性炎症反应综合征的重度糖尿病足. 中国修复重建外科杂志, 2018, 32(10): 1261-1266.
17.	Grüneboom A, Hawwari I, Weidner D, et al. A network of trans-cortical capillaries as mainstay for blood circulation in long bones. Nat Metab, 2019, 1(2): 236-250.

1. Shevtsov VI, Shurova EN, Shurov VA. Functional outcomes of legs obliterative endarteritis treatment by Ilizarov’s method. Khirurgiia (Mosk), 1997, (6): 47-50.
2. 曲龙, 王爱林, 汤福刚. 胫骨横向搬移血管再生术治疗血栓闭塞性脉管炎. 中华医学杂志, 2001, 81(10): 622-624.
3. 花奇凯, 王林, 冼呈, 等. Ilizarov 胫骨横向骨搬移微循环重建技术治疗下肢慢性缺血性疾病的临床疗效. 中国矫形外科杂志, 2015, 23(21): 2007-2011.
4. 张定伟, 秦泗河, 臧建成. Ilizarov 微循环重建技术治疗 Wagner4 级糖尿病足临床疗效分析. 中国矫形外科杂志, 2017, 25(4): 354-356.
5. 王林华, 周富强, 卢敏. 应用 Ilizarov 横向骨搬移技术微创截骨治疗糖尿病足 13 例. 中国中医骨伤科杂志, 2018, 26(11): 42-45.
6. 欧栓机, 齐勇, 孙鸿涛, 等. 经皮微创胫骨截骨横向骨搬移术治疗糖尿病足. 中国矫形外科杂志, 2018, 26(15): 1385-1389.
7. 冼呈, 赵劲民, 苏伟, 等. 胫骨横向骨搬移微循环再生技术治疗糖尿病足的临床疗效观察. 广西医科大学学报, 2015, 32(4): 605-607.
8. Chen Y, Kuang X, Zhou J, et al. Proximal tibial cortex transverse distraction facilitating healing and limb salvage in severe and recalcitrant diabetic foot ulcers. Clin Orthop Relat Res, 2020, 478(4): 836-851.
9. 田浩明, 李舍予. 长期血糖控制与糖尿病慢性血管并发症: 循证治疗三十年. 中华糖尿病杂志, 2016, 8(11): 641-644.
10. 中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南 (2019 版) (Ⅰ). 中华糖尿病杂志, 2019, 11(2): 92-108.
11. Li G, Simpson AH, Kenwright J, et al. Effect of lengthening rate on angiogenesis during distraction osteogenesis. J Orthop Res, 1999, 17(3): 362-367.
12. Xu J, Sun Y, Wu T, et al. Enhancement of bone regeneration with the accordion technique via HIF-1α/VEGF activation in a rat distraction osteogenesis model. J Tissue Eng Regen Med, 2018, 12(2): e1268-e1276.
13. 连浩宇. 干细胞动员在胫骨横向搬移治疗重度糖尿病足机制中的作用研究. 南宁: 广西医科大学, 2019.
14. 高伟. 重度糖尿病足横向骨搬移疗效与创面再生机制中巨噬细胞及表皮干细胞作用研究. 南宁: 广西医科大学, 2018.
15. 项杰. 胫骨横向骨搬移对糖尿病足患者造血干细胞集落形成及 PI3K/AKT 信号通路的影响. 南宁: 广西医科大学, 2018.
16. 镇普祥, 陈炎, 高伟, 等. 应用 Ilizarov 技术胫骨横向骨搬移术治疗合并全身性炎症反应综合征的重度糖尿病足. 中国修复重建外科杂志, 2018, 32(10): 1261-1266.
17. Grüneboom A, Hawwari I, Weidner D, et al. A network of trans-cortical capillaries as mainstay for blood circulation in long bones. Nat Metab, 2019, 1(2): 236-250.

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