Comparative Analysis Of Transverse Tibialbone Transport And Other Methods For Diabetic Foot Limb Salvage And Analysis Of Influencing Factors Of Major Amputation

Objective:We retrospectively analyzed the clinical data of Wagner patients with severe diabetic foot in our hospital,compared the difference of limb salvage rate among different methods,and analyzed the influencing factors of major amputation of diabetic foot in order to guide clinical treatment.Methods: The clinical data of diabetic foot patients hospitalized in our hospital from February 2012 to August 2016 was retrospectively reviewed.Telephone follow-ups which lasted from six months to five years were carried out on qualified patients to find whether they had major amputations above the ankle.The chi-square test was used to compare the differences of major amputation rate among different treatment methods if there were differences.Binary Logistic regression analysis was used to identify risk factors for theResults: 1.For patients with Wagner severe diabetic foot,three treatments were compared,which were conventional foot dressing treatment,wound treatment and transverse tibial bone transport,the major amputation rate difference being statistically significant(P<0.05);the major amputation rate difference of conventional foot dressing treatment group and wound treatment group was statistically insignificant(P=0.807,>0..0167);the major amputation rate difference between conventional dressing group and transverse tibial bone transport group and that between wound treatment group and transverse tibial bone transport group were statistically significant respectively(P=0.010 ?0.013,<0.0167).2.The results of binary Logistic regression analysis showed that(1)the major amputation risk for patients with Wagner severe diabetic foot who took conventional dressing treatment was 13.994 times that of transverse tibial bone transport treatment(OR=13.994,95% CI 1.533-127.740),(2)the major amputation risk for patients with Wagner severe diabetic foot who took wound treatment was 11.141 times that of transverse tibial bone transport treatment(OR=11.141,95% CI 1.298 to 95.630),(3)the major amputation risk of Wagner severe diabetic foot patients whose neutrophils percentage >75% was5.959 times that of patients whose neutrophils percentage ?75%(OR = 5.959,95% CI 1.528-223.246).Conclusion: For patients with Wagner severe diabetic foot,transverse tibial bone transport by Ilizarov technique for treatment of diabetic foot can improve the limb salvage rate,and effective control of systemic infection is beneficial to limb salvage.