New approaches to revascularizing osteotomy in the treatment of the neuroischemic form of diabetic foot syndrome
Authors:   Izhevsk State Medical Academy, Yu. Mikhaylov Aleksandr , N. Styazhkina Svetlana ,   Izhevsk State Medical Academy, V. Surnina Olga ,   Izhevsk State Medical Academy, R. Sharipkulov Bulat ,   Izhevsk State Medical Academy
Published: February 2025

Background. One of the most severe late complications of diabetes mellitus (DM) is the diabetic foot syndrome (DFS). Treating patients with DFS, especially with neuroischemic forms, demands a combined approach addressing hemodynamics, microcirculation, and neural function. The purpose of the research is to enhance the treatment outcomes for patients with neuroischemic DFS undergoing revascularizing osteotripanation (ROT) with intraosseous introduction of autologous platelet concentrate (APC). Materials and Methods. The study analyzed changes in limb hemodynamics using Doppler ultrasonography, neural function based on lower limb electroneuromyography, and changes in the quality of life of DFS patients through screening research methods. Two groups of neuroischemic DFS patients were formed: 36 patients received treatment according to the clinical recommendations of the Russian Ministry of Health in 2019. Additionally, apart from this treatment, 32 patients underwent revascularizing osteotripanation with the introduction of autologous platelet concentrate (ROT + APC). Statistical analysis was conducted using parametric and non-parametric analysis methods. Results. Improvement in limb hemodynamics was observed in patients undergoing ROT with APC according to Doppler ultrasonography. Enhanced neural function was established based on electromyography results, and an improvement in quality of life was noted within a three-month observation period. Positive effects in ulcerative defect treatment were achieved in 78.2 % of cases. Conclusions. The application of ROT + APC in the comprehensive treatment of neuroischemic DFS facilitates improvement in major limb blood flow, reduces distal diabetic neuropathy manifestations, and optimizes patient quality of life.Background. One of the most severe late complications of diabetes mellitus (DM) is the diabetic foot syndrome (DFS). Treating patients with DFS, especially with neuroischemic forms, demands a combined approach addressing hemodynamics, microcirculation, and neural function. The purpose of the research is to enhance the treatment outcomes for patients with neuroischemic DFS undergoing revascularizing osteotripanation (ROT) with intraosseous introduction of autologous platelet concentrate (APC). Materials and Methods. The study analyzed changes in limb hemodynamics using Doppler ultrasonography, neural function based on lower limb electroneuromyography, and changes in the quality of life of DFS patients through screening research methods. Two groups of neuroischemic DFS patients were formed: 36 patients received treatment according to the clinical recommendations of the Russian Ministry of Health in 2019. Additionally, apart from this treatment, 32 patients underwent revascularizing osteotripanation with the introduction of autologous platelet concentrate (ROT + APC). Statistical analysis was conducted using parametric and non-parametric analysis methods. Results. Improvement in limb hemodynamics was observed in patients undergoing ROT with APC according to Doppler ultrasonography. Enhanced neural function was established based on electromyography results, and an improvement in quality of life was noted within a three-month observation period. Positive effects in ulcerative defect treatment were achieved in 78.2 % of cases. Conclusions. The application of ROT + APC in the comprehensive treatment of neuroischemic DFS facilitates improvement in major limb blood flow, reduces distal diabetic neuropathy manifestations, and optimizes patient quality of life.