Evidence map›Paper›PMID 41502125›Full record

ArticleInternational wound journal2026

Automated Periosteal Distraction for Limb Salvage in Diabetic Foot Ulcers With Chronic Limb-Threatening Ischemia (Brief Communication).

Lucian M Feraru, Tze Woei Tan, David G Armstrong

Abstract readCase Reports
In one paragraph

Article in International wound journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Lucian M FeraruDepartment of Podiatric Surgery, Adventist Health White Memorial, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-8337-8505
Tze Woei TanDepartment of Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0002-6658-9482
David G ArmstrongDepartment of Surgery, Keck School of Medicine at the University of Southern California, Los Angeles, California, USA.ORCID https://orcid.org/0000-0003-1887-9175

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic limb-threatening ischemia (CLTI) compounded by diabetic foot ulceration remains a leading precursor to major lower-extremity amputation. Transverse tibial transport (TTT) can improve perfusion but requires corticotomy and bulky external fixation. We report what is, to our knowledge, the first application of fully automated tibial periosteal distraction (PD) for limb preservation. A 65-year-old man with recurrent forefoot gangrene underwent tibial PD using a miniaturised, programmable motor to gradually elevate the periosteum. Through a 1 cm incision, a low-profile subperiosteal plate was implanted and linked to the motor, which advanced 0.031 mm hourly (0.75 mm/day) up to 10 mm. Distraction was completed uneventfully over 13 days, and the device was removed at the bedside on Day 21. Skin temperature increased by 2°C, and digital systolic (toe) pressure rose from 22 to 50 mmHg. The wound progressed to healing without complication. Automated PD may offer a minimally invasive, biologically driven alternative for high-risk CLTI patients, eliminating the need for patient-adjusted screws and standardising adherence. Prospective studies are required to validate its safety, durability, optimal distraction parameters and cost-effectiveness.

Indexed as

Chronic Limb-Threatening IschemiaDiabetic FootIschemiaLimb SalvageOsteogenesis, DistractionPeriosteumAgedHumansMaleTibiaTreatment OutcomeWound Healing

Identifiers

PMID41502125
PMCPMC12780343

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.