Innovative Procedure
Saves Patient's Leg and Life
Bryan Medical Center continues to be a leader in new and innovative surgical care, now offering patients a transverse tibial bone transport (TBT) to help prevent lower limb amputations.
The TrueLok Elevate System is a limb-salvage procedure designed to restore blood flow, promote healing and significantly reduce the risk of amputation in patients with chronic, non-healing wounds and poor circulation conditions.
Dr. Jeffrey Wienke performed the first TBT with the TrueLok Elevate System at Bryan East Campus in late January. His patient is Jon Stander, 74, of Lincoln. The surgery lasted under an hour and went well.
Stander spent about a week in the hospital before being discharged to continue his recovery. The procedure also can be performed in an outpatient setting, allowing patients to go home the same day.
“Over 150,000 people undergo a lower leg amputation every year in the United States,” said Dr. Wienke, a podiatrist at Capital Foot and Ankle, part of the Bryan Physician Network. “The TrueLok Elevate System gives us a revolutionary alternative to treat these complex conditions and save limbs. This is a new era in the standard of care we offer and can really improve patient outcomes in the future.”
Stander developed large, severe wounds on his lower leg near his heel. He relied on canes and walkers for mobility. Despite treatment efforts, the sores worsened. Eventually, he moved into an assisted living facility and became dependent on a wheelchair. Amputation was an extremely uncertain option because of other existing health issues.
This procedure was the last chance to keep my leg below the knee. I thought, we have to try something. So, I agreed to it and was happy to do this.
— Jon Stander, Patient
During the procedure, a small segment of the tibia is cut and an external fixation device is implanted. Over the course of the next several weeks, adjustment knobs are manually turned to move the piece of bone one millimeter sideways every day. This controlled relocation creates a path for new blood vessels to form and grow. Patients or caregivers are trained on how to turn the device themselves.
After the piece of tibia is moved and blood flow is stimulated, the bone is gradually relocated to its regular position in the same way it was pulled away. Then, the bone is given time to heal and mature. About three to four weeks later, the external fixation device is removed and patients can resume activity with follow-up care.
Currently, Stander is just past the halfway point in recovery. His piece of tibia was docked in its temporary position and is now being moved back to its original location. New vessels are stimulating blood flow and he’s made significant progress. The area of Stander’s wound has decreased from the size of a racquetball to a marble. He has a positive prognosis and is on a healing path to save his lower leg and avoid significant risks associated with amputation.
“Dr. Wienke and his staff have been wonderful and I’ve had such a great experience,” Stander said. “After everything is healed, I look forward to settling down and enjoying all the activities at my facility and getting together with my kids and grandkids for family gatherings.”
Learn more at BryanHealth.org/FootCare.
