Abstract:Objective To investigate the efficacy of the double bone flap traction-modified tibial transverse transport（TTT）in the treatment of diabetic foot ulcers（DFU），and its impact on the ankle-brachial index（ABI），skin temperature，and Visual Analogue Scale（VAS）score of the affected limb. Methods A retrospective selection was made of 38 DFU patients admitted to the Department of Hand Microvascular Surgery of Dongguan People ’s Hospital from January 2022 to October 2024. According to the surgical method，they were divided into three groups：Group A（n=10，undergoing double bone flap traction-modified TTT），Group B（n=8，undergoing traditional TTT），and Group C（n=20，undergoing conventional debridement and wound revision）. The ABI，skin temperature，and VAS score of theaffected limb were compared among the three groups before surgery，one week after surgery，and one month after surgery. The marked improvement rate after 3 months of treatment，the healing time of small wounds，and the recurrence rate within six months after healing of small wounds were also compared. Results After surgery，Group A showed significant short -term improvement in ABI，skin temperature，and VAS score of the affected limb，and these parameters were significantly better than those in Groups B and C at one month postoperatively（P<0.05）. The follow-up period ranged from 6 to 15 months. During follow-up，there was a statistically significant difference in the marked improvement rate after 3 months of treatment among Groups A，B，and C［100.0%（10/10），75.0%（6/8），40.0%（8/20），χ2=10.925，P=0.004］. There was also a statistically significant difference in the healing time of small wounds among Groups A，B，and C［（2.9 ± 0.7）months，（4.1 ± 1.0）months，（4.3 ± 0.8）months，F=10.035，P=0.004］.Conclusion The double bone flap traction-modified TTT can significantly improve the microcirculation of the affected limb and shorten wound healing time，and its efficacy is significantly superior to that of traditional TTT and conventional debridement and wound enlargement.