Transverse Tibial Transport

What Is Transverse Tibial Transport?

Transverse Tibial Transport (TTT) is a novel vascular procedure used to improve blood circulation in the lower leg and foot. It is most often performed in patients with severe circulation problems that cause chronic wounds or ulcers that do not heal with conventional treatment. By slowly moving a small section of the tibia (shinbone) sideways using a specialized external device, surgeons stimulate the body to form new blood vessels and enhance tissue regeneration.

Transverse tibial transport is frequently used to treat complications associated with conditions such as diabetic foot ulcers and peripheral artery disease, particularly when poor circulation threatens the health of the foot.

When Is Transverse Tibial Transport Recommended?

Doctors may recommend transverse tibial transport when blood flow to the lower leg and foot is severely compromised and standard treatments have not been successful. This procedure is often considered as a limb-salvage option.

Common reasons it may be recommended include:

• Chronic non-healing foot ulcers
• Severe diabetic foot complications
• Critical limb ischemia due to poor circulation
• Chronic infections affecting the foot or ankle
• When there is a high risk of limb amputation

What Does Preparation for Transverse Tibial Transport Involve?

Preparation for transverse tibial transport typically begins with a thorough medical evaluation. Your orthopedic surgeon will review your medical history, medications, and overall health status.

Imaging studies such as X-rays, vascular studies, or CT scans may be performed to evaluate the bones and blood circulation in the leg. Blood tests and wound assessments are also commonly required.

Patients may be advised to control underlying conditions such as diabetes, stop smoking, and follow specific medication guidelines before surgery. Your care team will also explain the procedure and recovery process in detail.

How Is Transverse Tibial Transport Performed?

The procedure is usually performed under regional or general anesthesia. During surgery, a small rectangular section of the tibia (shinbone) is carefully cut but left attached to surrounding tissues.

An external fixation device is then attached to the leg. After a short healing period, the device is gradually adjusted to slowly move the bone segment sideways across the tibia. This controlled movement stimulates the formation of new blood vessels and improves blood flow to the foot.

The transport process typically occurs over several weeks.

What to Expect During Recovery After Transverse Tibial Transport?

Recovery involves careful monitoring and gradual adjustments of the external device. Patients may need regular follow-up visits so the surgeon can track progress and ensure proper bone movement.

Wound care, physical therapy, and management of underlying medical conditions are important parts of the recovery process. Many patients begin to notice improved circulation and gradual healing of chronic wounds over time.

What Are the Risks and Complications of Transverse Tibial Transport?

Like any surgical procedure, transverse tibial transport carries potential risks. Possible complications include:

• Infection around the surgical site or fixation pins
• Pain or discomfort during the bone transport phase
• Delayed bone healing
• Swelling in the lower leg
• Nerve or soft tissue irritation

What Are the Benefits of Transverse Tibial Transport?

For patients with severe circulation problems, transverse tibial transport can offer significant benefits.

Potential advantages include:

• Improved blood flow to the lower leg and foot
• Stimulation of new blood vessel growth
• Enhanced healing of chronic wounds and ulcers
• Reduced risk of amputation
• Preservation of limb function and mobility