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TTT System

Tibial Transverse Transport System

The Transverse Tibia Transport (TTT)-Treatment is a new surgical procedure which is based on the principles of Distraction Histogenesis (DH). With our TTT-System a small bone chip (5 x 1,5 cm) is slowly distracted transversely.

During the TTT-Treatment the body is generating his own Stem Cells and Growth Factors. The effect is not only locally but also systemically. 

The TTT-Treatment promotes the self-regenerative potential of living tissue and also Neo-Vascularisation.




How does it work? (the science behind)

Neo-Vascularization based on the principles of Distraction Histogenesis

Schematic illustration of local and systemic responses during Distraction Histogenesis (DH). 

At the site of distraction regenerate, expressions of various molecules including BMPs, inflammatory cytokines and angiogenic factors are regulated through during mechanotransduction. 

Furthermore, systemic effects of DH also contribute to musculoskeletal regeneration.


This Tibial Transverse Transport System is designed for advance the treatment of diabetic foot ulcer and peripheral avascular conditions. Due to its versatility, the system is specifically indicated for: 
— Diabetic foot with I to Ill grade ulcer (DFU) 
— Buerger disease (TAO) 
— Arterio sclerosis obliterans (ASO) 


Loss of popliteal artery pulse.
Other general contraindication for external fixators