Transverse Tibial Bone Transport (TTT) In The Management Of Chronic Diabetic Lower Extremity Wounds

Overview

About this study

The purpose of this study is to evaluate the safety and clinical performance of transverse tibial bone transport in patients with chronic ischemic and diabetic lower extremity ulcers. This study will assess wound healing outcomes and limb preservation in a population with limited therapeutic alternatives.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

* Adults (>=22 years).
* Chronic diabetic foot ulcer wound persisting >=12 weeks and less than 104 weeks refractory to standard wound care.
* Wound location within distal 1/3 tibia and below including foot.
* Wound stages: WiFi >= 3
* At least one patent lower extremity tibial vessel (after revascularization if needed).
* Able to provide informed consent and comply with study procedures.

Exclusion Criteria:

* Active systemic infection (positive blood cultures)
* Severe sepsis (2 out of 4 SIRS criteria with impact on organ dysfunction)
* Subacute lower extremity wound <12 weeks with or without standard wound cares
* Internal hardware within 10cm of possible TTT placement
* Most proximal aspect of wound within 10cm of most distal pin of possible TTT placement
* End Stage Renal Disease requiring dialysis
* Renal function values

* eGFR: <15ml/min and
* Creatinine: >6mg/dL and
* BUN: >50 mg/dL
* Wounds less than 1 cm3 or greater than 30 cm3
* Corticosteroids >10mg prednisone equivalent daily for >2 weeks
* Patients with osteomyelitis in the ipsilateral tibia at planned corticotomy site
* Cognitive or social limitations precluding consent or follow-up
* Current participation in another investigational study (drug or device)
* Immunocompromised (WBC <4) or undergoing active chemotherapy
* Hemoglobin A1c >12
* BMI <18.5 kg/m2
* Pregnant, lactating, or planning to become pregnant
* Life expectancy less than 12 months
* Severe hepatic impairment defined by patient on a transplant list, MELD > 20, Child's class C.
* A history of conditions that may impair wound healing in the opinion of the Investigator, for example, autoimmune disorders, renal failure patients on dialysis, or medications that impair the healing process.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 06/15/2026. Questions regarding updates should be directed to the study team contact.

 

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status

Jacksonville, Fla.

Mayo Clinic principal investigator

Elizabeth Wellings, M.D., M.S.

Contact us for the latest status

More information

Publications

Publications are currently not available

Additional contact information

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