Transverse Femoral Bone Transport for Refractory Diabetic Stump Ulceration: A Case Report

A 40-year-old woman with diabetes presented with a nonhealing, ischemic through-knee amputation stump. To avoid transfemoral amputation, we adapted the transverse bone transport technique for the femur, modifying the surgical procedure by using a tibial fixator. A dual-cycle cortical distraction protocol successfully induced local angiogenesis, transforming the avascular tissue into a granulating wound bed and allowing for primary closure and limb salvage.

Previously described only in the tibia, this first application of transverse bone transport provides compelling early evidence, 8 months postoperatively, that distraction-induced angiogenesis is a feasible and promising limb-salvage strategy for refractory amputation stumps at the femoral level.