{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T13:47:40Z","timestamp":1784296060986,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T00:00:00Z","timestamp":1762041600000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Chronic limb ischemia (CLI) is a significant health issue, particularly among patients with diabetes who are at elevated risk of diabetic foot ulcers (DFU) due to peripheral neuropathy and ischemia. In Singapore, approximately one in six adults is affected by diabetes, with a lifetime risk of developing DFU ranging from 15% to 25%. This paper examines the indications, surgical techniques and postoperative protocols for transverse tibial transport (TTT), an innovative limb salvage procedure implemented in a general hospital in Singapore and presents our early experience with this technique. All six patients in our study successfully achieved limb salvage with complete wound healing, with a median healing time of 4\u2009months. Four patients required additional wound debridement and skin coverage to facilitate healing. Importantly, none of the patients experienced pin site infections during the procedure or throughout the postoperative healing phase. Our study demonstrates favourable outcomes and underscores the clinical utility of TTT in augmenting the multimodal treatment of recalcitrant DFUs.<\/jats:p>","DOI":"10.1111\/iwj.70762","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T01:30:52Z","timestamp":1762133452000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Transverse Tibial Transport: Surgical Technique and Insights From First International Case Series"],"prefix":"10.1111","volume":"22","author":[{"given":"Jing Yuan","family":"Wong","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery National University Hospital (National University Health System)  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2950-8020","authenticated-orcid":false,"given":"Matthew","family":"Sebastian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Ng Teng Fong General Hospital (National University Health System)  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qikai","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Bone and Joint Surgery Guangxi Medical University  Nanning China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin Yik","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Ng Teng Fong General Hospital (National University Health System)  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H. P.","family":"Hui","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery National University Hospital (National University Health System)  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongsheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery National University Hospital (National University Health System)  Singapore"},{"name":"Department of Orthopaedic Surgery Ng Teng Fong General Hospital (National University Health System)  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.09.041"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2013-000012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2021.01.017"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1615439"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.05.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198901000-00038"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198902000-00029"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00001433-199512000-00012"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000238795.82466.74"},{"issue":"10","key":"e_1_2_11_11_1","first-page":"622","article-title":"The Therapy of Transverse Tibial Bone Transport and Vessel Regeneration Operation on Thromboangitis Obliterans","volume":"81","author":"Qu L.","year":"2001","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000001075"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-20-2053"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.10.001"},{"key":"e_1_2_11_15_1","first-page":"2007","article-title":"Clinical Effects of Ilizarov Tibial Transverse Transport and Microvascular Reconstruction Technique on Chronic Lower Limb Ischemic Diseases","volume":"23","author":"Hua Q.","year":"2015","journal-title":"Orthopaedic Journal of China"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2018.6321"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fastrc.2024.100420"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2024.110400"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.13214"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411006"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10456-013-9381-6"},{"issue":"36","key":"e_1_2_11_22_1","first-page":"5811","article-title":"Macrophages Promote the Healing of Severe Diabetic Foot Wounds After Tibial Transverse Transport","volume":"22","author":"Gao W.","year":"2018","journal-title":"Chinese Journal of Tissue Engineering Research"},{"key":"e_1_2_11_23_1","first-page":"15","article-title":"A Study of Pattern and Mechanism of Action of Wound Healing of Severe Diabetic Foot After Treatment With Transverse Tibial Bone Transport Surgery","volume":"31","author":"Lian H. 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Journal of Traditional Chinese Orthopedics & Trauma"},{"issue":"1","key":"e_1_2_11_24_1","first-page":"98","article-title":"Effect of Transverse Tibial Bone Transport on Expression of Serum Angiogenesis\u2010Related Growth Factors","volume":"34","author":"Ou S.","year":"2020","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi\u2009=\u2009Zhongguo Xiufu Chongjian Waike Zazhi\u2009=\u2009Chinese Journal of Reparative and Reconstructive Surgery"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S456590"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.06.005"},{"issue":"12","key":"e_1_2_11_27_1","first-page":"1576","article-title":"Application of Femoral\u2010Femoral Artery Bypass Grafting Combined With Transverse Tibial Bone Transporting for Lower Extremity Arteriosclerosis Obliterans or Combined With Diabetic Foot","volume":"32","author":"Wang B.","year":"2018","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"issue":"8","key":"e_1_2_11_28_1","first-page":"979","article-title":"Clinical Study on Treatment of Chronic Infection of Foot and Ankle With Lower Extremity Ischemic Diseases by Tibial Transverse Transport Combined With Antibiotic Embedded Bone Cement","volume":"34","author":"Wang D.","year":"2020","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04149-x"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70762","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:11:31Z","timestamp":1764029491000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70762"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":28,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1111\/iwj.70762"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70762","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"2025-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70762"}}