FDA-Cleared Procedures Available

You were told to amputate.
There is another way.

Two breakthrough procedures — periosteal distraction and transverse tibial transport — can restore blood flow to your leg and heal wounds that won't close. Thousands of limbs have already been saved.

FDA Cleared · No Osteotomy

Periosteal Distraction

A plate beneath the periosteum gently lifts the membrane, triggering new blood vessel growth through the bone. No bone is cut. Device removed at bedside after ~21 days.

90%
Wound healing
2.9%
Amputation rate
0
Osteotomies
Established · 1,000+ Patients

Transverse Tibial Transport

A small bone window is transported across the tibia using an external frame, triggering powerful angiogenesis to restore circulation. Effective when bypass isn't an option.

95%
Limb salvage
1,072
Patients studied
The Crisis

150,000 amputations a year. Most are preventable.

Diabetes is the leading cause of non-traumatic amputation in the United States. But new procedures are changing the equation.

⚠️
150K
Diabetes-related amputations in the U.S. every year
CDC / ADA
🩹
90%
Wound healing with periosteal distraction at 3 months
Zhou et al., BMC Medicine 2026
💚
95%
Limb salvage rate with transverse tibial transport
Chen et al., 2022
🕑
30s
Every 30 seconds, a limb is lost to diabetes worldwide
IDF Diabetes Atlas
The Procedures

Two procedures that are saving limbs

Both work by triggering your body to grow new blood vessels — restoring the circulation your wounds need to heal.

FDA Cleared · No Osteotomy

Periosteal Distraction

A small plate is placed beneath the periosteum — the living membrane on your shin bone. The plate gently lifts it, triggering your body to grow new blood vessels through the bone. Then the device is removed at bedside.

  • No bone is cut — your tibia stays completely intact
  • Minimally invasive — small incision, outpatient
  • Device removed at bedside after ~21 days
  • FDA 510(k) cleared for U.S. use
90%
Wound healing
2.9%
Amputation rate
21 days
Typical duration
Full clinical details →
Established · 1,000+ Patients

Transverse Tibial Transport

A small window of bone is cut from the shin and slowly moved using an external frame. This controlled movement triggers powerful angiogenesis — new blood vessels form to restore circulation to ischemic tissue.

  • Based on proven Ilizarov distraction principles
  • Over 1,000 patients in published studies
  • Effective when bypass surgery isn't an option
  • External frame worn for 6–8 weeks
95%
Limb salvage
1,072
Patients studied
Full clinical details →
Your Path Forward

From diagnosis to recovery

Here's what the journey looks like — from the moment you decide to fight for your limb.

1

Get a second opinion

If you've been told you need an amputation, see a limb-salvage specialist. Many patients discover options they were never told about.

2

Clinical evaluation

Your specialist evaluates your circulation, wound, and overall health to determine if PD, TTT, or another approach is right for you.

3

The procedure

A device is placed on your shin bone. Over several weeks, it triggers your body to grow new blood vessels — restoring blood flow your wound needs.

4

Healing & recovery

New circulation reaches your foot and wounds begin closing. Most patients see significant healing within 3 months. You keep your leg.

Self-Assessment

Could this work for me?

These procedures help many patients who've been told nothing else can be done. While only a specialist can confirm candidacy, here are the signs to look for.

Talk to a Specialist

! Warning signs you need help

  • A foot or leg wound that won't heal despite treatment
  • Told you need a below-knee or above-knee amputation
  • Peripheral arterial disease (PAD) or critical limb ischemia
  • Bypass surgery or stenting is not an option

Good signs for success

  • Your shin bone (tibia) is intact and healthy
  • Infection is controlled or controllable
  • You're medically stable for a minor procedure
  • Committed to follow-up wound care

Your next step

  • Ask your doctor about periosteal distraction or TTT
  • Request a referral to a limb-salvage specialist
  • Bring this page to your next appointment
  • Use our directory to find a specialist near you

Important: This information is educational and does not constitute medical advice. Only a qualified limb-salvage specialist can determine if these procedures are appropriate for you. The most important step is scheduling a consultation.

Patient Stories

They were told to amputate. They didn't.

Real patients who chose to fight for their limbs.

"Three doctors told me they had to take my leg. The fourth told me about a procedure I'd never heard of. That was two years ago. I'm still walking on both legs."
R
Robert M.
Age 64 · Type 2 Diabetes · Non-healing ulcer, 8 months
✓ Wound healed at 10 weeks
"My daughter found information online and wouldn't give up. She drove me four hours to see a specialist. That decision saved my leg — and probably my life."
M
Maria L.
Age 71 · Type 2 Diabetes · Critical limb ischemia
✓ Walking independently at 4 months
"I'd already lost toes. They said the rest of my foot was next. After the procedure, blood started flowing again and the wound finally closed. I kept my foot."
J
James T.
Age 58 · Type 2 Diabetes · Previous partial amputation
✓ No further amputation required
Surgeon Directory

Find a limb-salvage specialist

Surgeons and practices performing periosteal distraction and transverse tibial transport. Search by ZIP code to find the nearest specialist, or search by name, city, or state.

Are you a surgeon performing limb-salvage procedures? We're building the most comprehensive directory of specialists. Contact us to be listed. This directory is continuously updated as more surgeons adopt these procedures.

FAQ

Common questions

What patients and families want to know.

Yes. Both procedures restore blood flow by triggering angiogenesis — the growth of new blood vessels. PD achieved 90% wound healing; TTT has 95% limb salvage rates. They aren't for every patient, but for many facing amputation, they offer a real path forward.

Periosteal distraction has received FDA 510(k) clearance. TTT uses standard external fixation components that are also FDA-cleared. Both are performed by trained surgeons in hospital or outpatient settings.

Both restore blood flow through distraction-induced angiogenesis. PD lifts the periosteum without cutting bone. TTT cuts a small bone window and transports it across the tibia. Your specialist will recommend the best option for your situation.

Coverage varies. Since amputation and its lifelong consequences are far more costly, many insurers recognize limb-salvage procedures. Your doctor's office can help verify coverage.

The device is in place for 3–8 weeks depending on the procedure. Most patients see wound improvement within weeks, with full healing at 3–6 months.

These procedures are relatively new in the U.S. Bring this information to your appointment and ask for a referral to a limb-salvage specialist. You have the right to a second opinion.

Performed under anesthesia. During distraction, adjustment is less than 1 mm/day — most patients tolerate it well. Many say chronic wound pain was far worse.

Look for orthopedic or podiatric surgeons with training in limb reconstruction or Ilizarov techniques. Our directory (launching soon) will help you find qualified specialists near you.

Every limb saved is a life changed.

If you or someone you love has been told amputation is the only option, take the first step. A second opinion could change everything.

Find a Specialist Near You