Wishbone Transverse Bone Transport System

Built on the Ilizarov tension-stress principle and engineered with modern orthopedic technology, this system provides a minimally invasive, economical, and clinically proven approach for managing severe vascular insufficiency of the lower extremities.

Indications:
versatility, the system is specifically indicated for:
Wishbone external frame is designed for advanced the treatment of diabetic foot ulcer and peripheral avascular conditions. Due to its
-- Diabetic foot with Ⅰ to Ⅲ grade ulcer
-- Buerger disease (TAO)
-- Arteriosclerosis obliterans (ASO)

Contraindications:
Loss of popliteal artery pulse.
Other general contraindications for external fixators.

Features & Benefits:

Inspired from the Ilizarov tension-stress principle, by regularly transverse lengthening of the bone chip, rebuilt the microvascular network, gradual increase of blood supply to the whole limb, enhanced circulation to the distal part of the leg and foot. This enhanced blood circulation network shall remain for at least 12 months following this procedure.
- After 2 years with more than 120 cases of clinical research, the Wishbone® system has been proved as an effective treatment to solve a wide range of the ischemic disease of lower extremity, especially offering an easy and economical way for healing the diabetic feet with I to III grade.
- The patented frame with low profile design makes the surgery simple and easy to be operated.
- The optimized design of the drill guide offers a minimally-invasive osteotomy.

-- The misalignment design of anchor pins and distracting pins avoids the difficulty of transverse transport.	-- Rotatable distracting pin clamp, more flexible for pin placement, easier for operation.
-- Equipped with central clamps in 2 sizes which are adapted to respective guide plates.	-- 2-hole or 3-hole drill guide can be used for minimally invasive osteotomy.

Ilizarov discovered the phenomenon of rich vascular network formation during distraction osteogenesis for limb regeneration and the tension-stress rule could activate and enhance the regenerative potentials of living tissues, leading to functional reconstruction, growth or regeneration of (muscles, fascia, blood vessels, and nerves simultaneously. Orthopaedic surgeons in China applied the tibial cortex transverse transport (TTT) technique to reconstruct limb microcirculation, to treat lower extremity microvascular lesions and diabetic foot ulcers since 2001. Clinical studies from China demonstrated that the TTT technique could effectively regenerate the microvascular network in the lower limbs of diabetic patients, promote ulcer healing and reduce the amputation rate. As a novel treatment for severe diabetic foot ulcers (DFU), the TTT technique may be adopted in different countries to benefit DFU patients worldwide.

Operative Technique:

Ⅰ.Position the Wishbone fixator.
Perform a slightly curved incision of 5~6 cm in the middle shaft of the affected tibia, separate the periosteum, expose the bone. 
Insert 2 pins (2.5 mm K-wire) for aiming holes on both sides to position the guide plate.

Determine the dimension of the bone chip with corresponding sizes of the plate, perform the first osteotomy with the oscillating saw from A to C side with constant irrigation and cooling.
Remove the plate and pins, cover the flaps and insert the first two 3.0 mm pins percutaneously via the same path of the 2.5 mm K-wire, penetrating the first cortex of the bone chip.
Perform the second cut on D side to release the chip and make the bone window down.
Position the fixator by locking the two 3.0 mm Schanz pins on the move-bar then insert two 5.0 mm half pins bicortically via outer clamps on the main bar. Tighten all the units to lock the frame.

II. Transverse lengthening procedure “Accordion movement”
The transverse lengthening of the bone chip starts 7 days after the surgery.

Release the front nut, turning the knob clockwise on the main bar by 3 “clicks”. After 6 hours, re-perform this procedure. Ensure 2 times
daily to procure a 1 mm distraction.
This procedure needs to be done regularly for 10 days then start compressing back the bone chip by turning the knob reversely with the
same method for another 10 days.
Once the bone chip is back to normal position at the tibial shaft, the total procedure may be repeated once again. The total treatment
period is about 6–8 weeks. 
Clinical research shows, based on Prof. Li’s clinical observations of more than 120 cases treated by this procedure in 2 years. The patients
start to feel warmer after 2 days in the period of the distraction. There exists a constantly increase of blood supply to the whole affected limbs and the new network of the microvascular has been rebuilt in diabetic foot cases, the ulcers begin to heal at around 3–4 weeks and will not normally occur at the same location.

Case 1

A patient suffered from diabetic foot. Before the surgery, existed the ulcer grade II. After 4 weeks of the surgery and treatment, the ulcer started healing. 8 weeks after the surgery, the ulcer has completely been healed due to the effective treatment of the Wishbone system.

A: In general, for small orders, we will ship within three days of placing the order. For large orders, we will ship within ten days after placing the order. For customized orders, it will take around 45-60 days.

2. Q: How do you ship?
A: Generally, we ship products via DHL, FedEx, TNT, UPS, etc. Of course, when the order is large, we can also find a freight forwarder to ship by sea or air. If you can find a freight forwarder yourself, we can also accept it.

3. Q: How to pay?
A: You can pay by T/T, Western Union, Paypal,MoneyGram, etc.

4. Q:How is your warranty?
A:We provide two years warranty for handpiece, half year for accessories like battery etc. To ensure the qualifi Double check before shipment. We have a qualified inspector who checks the finished products when the products are shipped to the warehouse AND double check before shipment.

5. Q: Can I visit your factory?
A: Of course, we will make a detailed schedule before your visit, and we will serve you all the time.