微创骨膜牵张技术应用于中老年多合并症缺血性糖尿病足的保肢价值与功能预后分析

Objective To investigate the efficacy of minimally invasive periosteal distraction technique in limb salvage and its impact on functional prognosis in middle-aged and elderly patients with ischemic diabetic foot and multiple comorbidities. Methods A total of 14 middle-aged and elderly patients with ischemic diabetic foot admitted from July 2023 to December 2025 were enrolled. All patients received minimally invasive periosteal distraction surgery combined with basic medical treatment. A self-controlled before-after design was adopted. Limb blood supply indicators, pain intensity, wound healing status, limb salvage rate, and activities of daily living were compared before and after surgery, and surgery-related complications were recorded. Results At 3 months postoperatively, dorsal foot skin temperature, ankle-brachial index, and transcutaneous oxygen partial pressure were significantly higher than preoperative values, while the visual analogue scale pain score was significantly lower(P<0.05). At 6 months postoperatively, the limb salvage rate was 92.86%, the average wound healing time was(29.76±5.38) days, and 12 patients showed an improvement of at least one grade in Wagner classification. The activities of daily living score was significantly improved compared with baseline(P<0.05). The overall incidence of surgery-related complications was 7.14%, with no severe complications such as fracture or nonunion observed. Conclusion Minimally invasive periosteal distraction technique can effectively improve blood supply to the affected limb, alleviate pain, increase the limb salvage rate, promote wound healing, and enhance daily living activities in middle-aged and elderly patients with ischemic diabetic foot and multiple comorbidities. It demonstrates good safety and is worthy of clinical promotion.