{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T07:47:25Z","timestamp":1793692045745,"version":"4.5.1"},"reference-count":80,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T00:00:00Z","timestamp":1651881600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tibial cortex transverse transport (TTT) surgery is an extension of the Ilizarov technique. Based on the law of tension\u2010stress, its primary function is to rebuild microcirculation which can relieve ischemic symptoms and promote wound healing. It has received more and more scholars' attention and has experienced a series of changes for 20\u2009years since it entered PR China. The mechanisms involved have gradually become clear, such as the reconstruction of the polarization balance of macrophages, the promotion of vascular tissue regeneration, and the mobilization and regulation of bone marrow\u2010derived stem cells. TTT technique is mainly used in the treatment of chronic ischemic diseases of the lower extremities. It has recently been successfully used in the treatment of primary lymphedema of the lower extremities. A series of improvements have been made in the external fixator's style, the size of skin incision and osteotomy, and distraction method. For example, the annular external fixator has been redesigned as a unilateral external fixator, and accordion technology has been introduced. For distraction methods after surgery, there was no uniform standard in the past. The technique can also be used in combination with other treatments to achieve better effects, such as interventional therapy, negative pressure sealed drainage, 3D printing technology, traditional Chinese medicine. Nevertheless, the surgery may bring some complications, such as secondary fracture, nail infection, skin necrosis at the surgical site, etc. Reports of complications and doubts about the technique have made the TTT technique controversial. In 2020, the relevant expert consensus was published with treatment and management principles, which might guide the better application and development of this technique.<\/jats:p>","DOI":"10.1111\/os.13214","type":"journal-article","created":{"date-parts":[[2022,5,7]],"date-time":"2022-05-07T10:05:02Z","timestamp":1651917902000},"page":"1034-1048","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Twenty Years Development of Tibial Cortex Transverse Transport Surgery in <scp>PR<\/scp> China"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8176-2482","authenticated-orcid":false,"given":"Zheng","family":"Liu","sequence":"first","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Xu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"},{"name":"The Second Affiliated Hospital of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7639-9984","authenticated-orcid":false,"given":"Yi\u2010kang","family":"Yu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2626-8833","authenticated-orcid":false,"given":"Dong\u2010peng","family":"Tu","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Peng","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Clinical Medical College of Zhejiang Chinese Medical University  Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,7]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"994","article-title":"Research progress of tibial transverse transport in treatment of chronic ischemic diseases of the lower extremities","volume":"34","author":"Liu Z","year":"2020","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jot.2020.09.005"},{"key":"e_1_2_5_4_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_5_5_1","first-page":"642","article-title":"Technical overview of Ilizarov","volume":"26","author":"Qin SH","year":"2006","journal-title":"Zhonghua Gu Ke Za Zhi"},{"key":"e_1_2_5_6_1","first-page":"951","article-title":"Ilizarov's tibial transverse transport technique in the past, present and afterlife\u2014the history of the birth of a treatment","volume":"34","author":"Qu L","year":"2020","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198901000-00038"},{"key":"e_1_2_5_8_1","first-page":"1469","article-title":"Treatment of bone infection, bone defect and soft tissue defect by bone displacement","volume":"42","author":"Qu L","year":"2004","journal-title":"Chin J Surg"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature07039"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0478-y"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addr.2018.02.007"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411006"},{"key":"e_1_2_5_13_1","unstructured":"GaoW.Effect of transverse bone transport on severe diabetic foot and mechanism of wound regeneration with macrophages and epidermal stem cells. 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