Clinical outcomes of tibial cortex transverse transport versus antibiotic-loaded bone cement for Wagner grade 3–4 diabetic foot ulcers: a real-world retrospective cohort study - Summary - MDSpire
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Clinical outcomes of tibial cortex transverse transport versus antibiotic-loaded bone cement for Wagner grade 3–4 diabetic foot ulcers: a real-world retrospective cohort study
To compare the effectiveness of tibial cortex transverse transport (TTT) and antibiotic-loaded bone cement (ALBC) in managing Wagner grade 3–4 diabetic foot ulcers (DFUs), emphasizing the comparative nature of the study.
Key Findings:
No significant differences in percentage area reduction (PAR) at 3 months or rates of major amputation between TTT and ALBC groups.
TTT group showed significantly higher PAR at 6 months for Wagner grade 4 DFUs (P = 0.002) and lower URTOR rates (P = 0.018).
For Wagner grade 3 DFUs, TTT also demonstrated a lower URTOR rate (P = 0.012).
TTT group had greater improvement in ABI (P < 0.05), while ALBC had a shorter time to infection clearance (P < 0.001).
TTT was independently associated with lower odds of URTOR compared to ALBC.
Interpretation:
ALBC and TTT are distinct surgical strategies for managing Wagner grade 3–4 DFUs, with ALBC focusing on infection control and TTT on improving perfusion, highlighting the need for tailored clinical approaches.
Limitations:
Retrospective design may introduce selection bias.
Findings are based on a single center's data, which may limit generalizability and does not account for potential confounding factors.
Conclusion:
TTT may be more effective for improving perfusion and reducing reintervention rates, particularly in Wagner grade 4 ulcers, while ALBC is associated with faster infection clearance, underscoring the importance of individualized treatment strategies.
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