Abstract
AIMS: Tibial cortex transverse transport (TTT) represents an innovative surgical technique used in managing lower limb ischaemic conditions, focusing specifically on diabetic foot ulcers. This study aimed to assess the safety of TTT by evaluating the stress magnitude and distribution on the tibia and tibial osteotomy blocks. METHODS: A 3D finite element model was developed to simulate the TTT system, including the tibia, osteotomy blocks, skin, and TTT device. The models were reconstructed using Mimics, Geomagic, and SolidWorks, and analyzed with Ansys finite element processing software. To estimate the fracture risk under specific conditions, we calculated the stress limits and distribution the tibia could withstand without fracturing under various loading scenarios, such as torsion and axial compression. RESULTS: The results indicate that stress on the tibial cortex increased progressively with the advancement of bone transport fixation adjustment, and was primarily concentrated around the pinholes used to lift the osteotomy block. No significant differences were observed between the control and TTT groups. CONCLUSION: Through finite element analysis, it was determined that TTT does not compromise the overall stability of the tibia, and the TTT device provides protection against bone fracture caused by window-cutting in diabetic patients. Therefore, to preserve the TTT system's stability, its components must be protected from high-impact forces.