


Indicated for treatment of diabetic foot ulcer/TAO/ASO




The Transverse Tibia Transport (TTT)-Treatment is a new surgical procedure which is based on the principles of Distraction Histogenesis (DH). With our TTT-System a small bone chip (5 x 1,5 cm) is slowly distracted transversely.
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During the TTT-Treatment the body is generating his own Stem Cells and Growth Factors. The effect is not only locally but also systemically.
The TTT-Treatment promotes the self-regenerative potential of living tissue and also
Neo-Vascularisation.
How does it work? (the science behind)

Neo-Vascularization based on the
principles of Distraction Histogenesis
Schematic illustration of local and systemic responses during Distraction Histogenesis (DH).
At the site of distraction regenerate, expressions of various molecules including BMPs, inflammatory cytokines and angiogenic factors are regulated through during mechanotransduction.
Furthermore, systemic effects of DH also contribute to musculoskeletal regeneration.
* Kong et al.,; An update to the advances in understanding distraction histogenesis: From biological mechanisms to novel clinical applications, Journal of Orthopedic Translation (JOT), 2020
CLINICAL RESULTS

Preoperative and postoperative perfusion maps show increased blood flow and volume in feet with diabetic foot ulcers treated with tibial cortex transverse
distraction after 3 months
Chen Yan et al.; Proximal Tibial Cortex Transverse Distraction Facilitating Healing and Limb Salvage in Severe and Recalcitrant Diabetic Foot Ulcers, Clin Orthop Relat Res (2019) 00:1-16

A Wagner 3 DFU (Female 62 year, foot ulcer)
B After Debridement
C 1 week after TTT Surgery
D 2 weeks after TTT Surgery
E 4 weeks after TTT Surgery
F 6 weeks after TTT Surgery
Li Gang, Samual K.K. Ling et al.; How to perform minimal invasive tibial cortex transport surgery, Journal of Orthopaedic Translation, Volume 25, November 2020

Li Gang, Samual K.K. Ling et al.; How to perform minimal invasive tibial cortex transport surgery, Journal of Orthopaedic Translation, Volume 25, November 2020
Tibial Transverse Transport System
THE INDICATIONS
This Tibial Transverse Transport System is designed for advance the treatment of diabetic foot ulcer and peripheral avascular conditions. Due to its versatility, the system is specifically indicated for:
-- Diabetic foot with I to Ill grade ulcer (DFU)
-- Buerger disease (TAO)
-- Arterio sclerosis obliterans (ASO)
THE CONTRAINDICATIONS
Loss of popliteal artery pulse.
Other general contraindication for external fixators.
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