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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2.	曲龍, 王愛林, 湯福剛. 脛骨橫向搬移血管再生術治療血栓閉塞性脈管炎. 中華醫學雜志, 2001, 81(10): 622-624.
3.	花奇凱, 王林, 冼呈, 等. Ilizarov 脛骨橫向骨搬移微循環重建技術治療下肢慢性缺血性疾病的臨床療效. 中國矯形外科雜志, 2015, 23(21): 2007-2011.
4.	張定偉, 秦泗河, 臧建成. Ilizarov 微循環重建技術治療 Wagner4 級糖尿病足臨床療效分析. 中國矯形外科雜志, 2017, 25(4): 354-356.
5.	王林華, 周富強, 盧敏. 應用 Ilizarov 橫向骨搬移技術微創截骨治療糖尿病足 13 例. 中國中醫骨傷科雜志, 2018, 26(11): 42-45.
6.	歐栓機, 齊勇, 孫鴻濤, 等. 經皮微創脛骨截骨橫向骨搬移術治療糖尿病足. 中國矯形外科雜志, 2018, 26(15): 1385-1389.
7.	冼呈, 趙勁民, 蘇偉, 等. 脛骨橫向骨搬移微循環再生技術治療糖尿病足的臨床療效觀察. 廣西醫科大學學報, 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. 長期血糖控制與糖尿病慢性血管并發癥: 循證治療三十年. 中華糖尿病雜志, 2016, 8(11): 641-644.
10.	中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南 (2019 版) (Ⅰ). 中華糖尿病雜志, 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.	連浩宇. 干細胞動員在脛骨橫向搬移治療重度糖尿病足機制中的作用研究. 南寧: 廣西醫科大學, 2019.
14.	高偉. 重度糖尿病足橫向骨搬移療效與創面再生機制中巨噬細胞及表皮干細胞作用研究. 南寧: 廣西醫科大學, 2018.
15.	項杰. 脛骨橫向骨搬移對糖尿病足患者造血干細胞集落形成及 PI3K/AKT 信號通路的影響. 南寧: 廣西醫科大學, 2018.
16.	鎮普祥, 陳炎, 高偉, 等. 應用 Ilizarov 技術脛骨橫向骨搬移術治療合并全身性炎癥反應綜合征的重度糖尿病足. 中國修復重建外科雜志, 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. 曲龍, 王愛林, 湯福剛. 脛骨橫向搬移血管再生術治療血栓閉塞性脈管炎. 中華醫學雜志, 2001, 81(10): 622-624.
3. 花奇凱, 王林, 冼呈, 等. Ilizarov 脛骨橫向骨搬移微循環重建技術治療下肢慢性缺血性疾病的臨床療效. 中國矯形外科雜志, 2015, 23(21): 2007-2011.
4. 張定偉, 秦泗河, 臧建成. Ilizarov 微循環重建技術治療 Wagner4 級糖尿病足臨床療效分析. 中國矯形外科雜志, 2017, 25(4): 354-356.
5. 王林華, 周富強, 盧敏. 應用 Ilizarov 橫向骨搬移技術微創截骨治療糖尿病足 13 例. 中國中醫骨傷科雜志, 2018, 26(11): 42-45.
6. 歐栓機, 齊勇, 孫鴻濤, 等. 經皮微創脛骨截骨橫向骨搬移術治療糖尿病足. 中國矯形外科雜志, 2018, 26(15): 1385-1389.
7. 冼呈, 趙勁民, 蘇偉, 等. 脛骨橫向骨搬移微循環再生技術治療糖尿病足的臨床療效觀察. 廣西醫科大學學報, 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. 長期血糖控制與糖尿病慢性血管并發癥: 循證治療三十年. 中華糖尿病雜志, 2016, 8(11): 641-644.
10. 中華醫學會糖尿病學分會, 中華醫學會感染病學分會, 中華醫學會組織修復與再生分會. 中國糖尿病足防治指南 (2019 版) (Ⅰ). 中華糖尿病雜志, 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. 連浩宇. 干細胞動員在脛骨橫向搬移治療重度糖尿病足機制中的作用研究. 南寧: 廣西醫科大學, 2019.
14. 高偉. 重度糖尿病足橫向骨搬移療效與創面再生機制中巨噬細胞及表皮干細胞作用研究. 南寧: 廣西醫科大學, 2018.
15. 項杰. 脛骨橫向骨搬移對糖尿病足患者造血干細胞集落形成及 PI3K/AKT 信號通路的影響. 南寧: 廣西醫科大學, 2018.
16. 鎮普祥, 陳炎, 高偉, 等. 應用 Ilizarov 技術脛骨橫向骨搬移術治療合并全身性炎癥反應綜合征的重度糖尿病足. 中國修復重建外科雜志, 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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