DYNEX®TRIAD

DYNEX® TRIAD is a dedicated external fixation system for Tibial Cortex Transverse Transport (TTT). Based on published literature, TTT is a limb-preservation procedure that can promote wound healing in recalcitrant diabetic foot ulcers (DFU) and ischemic lower extremity wounds through induction of angiogenesis.

Transverse Tibial Transport (TTT)

A limb-salvage surgical technique used to support healing in severe diabetic foot ulceration through distraction-induced angiogenesis and microvascular remodeling.

Published outcomes from TTT procedures in recalcitrant diabetic foot ulcers report wound healing rates of 92–96% at one-year follow-up, with amputation rates of 1.9–4.9% — compared to a lifetime amputation rate of 15–20% in conventionally managed DFU.^1,2,3

TECHNIQUE

Tibial Cortex Transverse Transport

FOCUS

Limb Salvage / Perfusion Support

Surgical Principle

A unicortical medial tibial bone window is created and gradually transported laterally over approximately two weeks before being returned to its original position.

Mechanism of Action

Controlled distraction is believed to stimulate angiogenesis, collateral vessel formation, and improved microvascular perfusion to the distal extremity.

Clinical Context

TTT has been described as an adjunctive limb-salvage strategy in patients with severe diabetic foot ulceration and compromised tissue perfusion.

1. Chen Y, et al. Effect of tibial cortex transverse transport in patients with recalcitrant diabetic foot ulcers: a prospective multicenter cohort study. J Orthop Translat. 2022;36:194-204.
2. Yuan Y, et al. Tibial cortex transverse transport accelerates wound healing via enhanced angiogenesis and immunomodulation. Bone Joint Res. 2022;11(4):189-199.
3. Efficacy of tibial cortex transverse transport in treating diabetic foot ulcer. Diabetol Metab Syndr. 2024;16:160.

Bone Transport, Simplified

Pre-assembled fixator designed for quick fixation. MIS Corticotomy Guide for fast, reproducible results and minimal soft tissue envelope disruption.

Techniques

The DYNEX® TRIAD TTT system has three available techniques that can be used in procedure: Flap, MIS, and Freehand.

Integrated with DYNEX®

TRIAD can be used as a standalone device or in conjunction with the DYNEX® External Fixation system, half pins, rings, and accessories, for increased stability during transport.

Progress Scale & Movement

TRIAD features a total running distance of 10mm. Movement progress is indicated by the integrated scale along the front of the fixator. Movement is shown from 0-10mm in 1mm increments for precise progress readings.

Indicator Dots

Adjustment Knob rotates both clockwise for distraction and counter-clockwise for compression.

Each quarter turn results in 0.25mm adjustments, and features indicator dice to confirm the adjustment. 1.0mm of adjustment is possible per full revolution.