The discovery and clinical significance of the “twin open skylight and summon effects” of the Ilizarov tibial transverse transport technique

Ilizarov’s tibial transverse transport (TTT) technique can promote vascular regeneration. It has been used in the treatment of a variety of lower limb ischemic diseases, such as thromboangiitis obliterans, diabetic foot ulcers, etc. Recently, several novel therapeutic effects have been discovered based on TTT treatment. For instance, in the treatment of thromboangiitis obliterans, an “Open Skylight Effect” was well defined in which the symptom of resting pain disappeared following tibial cortex osteotomy (Long Qu, 2001). During the treatment of bilateral diabetic foot gangrene, patients that received TTT treatment on the one side of the lower limb were observed to have a simultaneous healing of ulcers on both sides, which was termed as the “Summon Effect” (Qikai Hua, 2017). In 2019, we characterized the above discoveries as the “Twin Open Skylight and Summon Effects”. These findings will inspire more potential clinical applications of TTT technique.