Scholastic Case Reports
(ISSN: 3108-1827)
Modified Tibial Cortex Transverse Transport for Diabetic Foot Ulcers and Its Implications in Contemporary Diabetes Management
Rebeca Diógenes
Acadêmica de Medicina pela Universidade Christus. Fortaleza - Ceará - Brazil.
Corresponding Author: Rebeca Diógene, Acadêmica de Medicina pela Universidade Christus. Fortaleza - Ceará - Brazil.
Received: January 28, 2026; Published: February 18, 2026
Abstract
Diabetic foot ulcers (DFU) remain a major cause of morbidity, lower limb amputation, and health expenditures worldwide. Modified tibial cortex
transverse transport (MTCTT) is an adaptation of tibial cortex transverse transport (TTT), designed to improve lower limb microcirculation via
controlled cortical bone distraction while reducing tibial complications. A retrospective study of 98 patients with Wagner grade ≥ II DFU treated with MTCTT demonstrated a
wound healing rate of 95.83%, mean healing time of 53.18 / 20.18 days, significant improvement in ankle–brachial index (ABI), Wound/Ischemia/foot Infection (WIfI) score,
and pain, with a complication rate of 8.16% and no ulcer recurrence during follow-up. Recent systematic reviews of TTT in diabetic and ischemic lower limb ulcers
corroborate high healing and limb salvage rates with low incidence of pin-site infection and tibial fracture. This article synthesizes current evidence on MTCTT, discusses its mechanisms, indications, and limitations, and analyzes its role within modern multidisciplinary diabetes care.[2][5][3][4][1]
Keywords: diabetic foot ulcer; tibial cortex transverse transport; modified tibial cortex transverse transport; limb salvage; microcirculation; diabetes mellitus.[3][2]
References
- Liu J, Yao Y, Xu X, Wu H, Pei F, Zhang Z, et al (2024). Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients. Front Endocrinol (Lausanne) 15:1334414.[8][2]
- Liu J, Yao Y, Xu X, Wu H, Pei F, Zhang Z, et al. Modified tibial cortex transverse transport for diabetic foot ulcers with Wagner grade ≥ II: a study of 98 patients. PubMed abstract.[1]
- Xu Z, et al (2025). Clinical guidelines for the application of tibial cortex transverse transport in the management of complex diabetic foot disease. Diabetes Metab Syndr Obes (ahead of print).[7][6]
- A Systematic Review on Tibial Cortex Transverse Transport in the Treatment of Ischemic Ulcers of the Lower Limb (2025). Foot Ankle Int. 46(9).[3][4]
- Management of severe diabetic foot using modified transverse bone transport. J Orthop Res. 2025; (epub ahead of print).[10]
- Comparison of clinical efficacy between tibial cortex transverse transport and platelet-rich plasma for severe diabetic foot ulcers. Front Surg. 2025;12:1507982.[11]
- Tibial cortex transverse transport: historical evolution, clinical applications, and perspectives. Current Diabetes Reports. 2025; (review).[7]
Citation: Rebeca Diógenes. “Modified Tibial Cortex Transverse Transport for Diabetic Foot Ulcers and Its Implications in Contemporary Diabetes Management”. Scholastic Case Reports 2.2 (2026): 01-03.
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