Salvaging a segmental defect of the tibia using the Huntington’s procedure: A case report
Journal Title: National Journal of Clinical Orthopaedics - Year 2018, Vol 2, Issue 3
Abstract
Background: Historically, gap non-unions of the tibia arising due to infections or trauma resulted in an amputation. However, with the advent of modern surgical techniques, such injuries can now be salvaged. Various techniques have been described in literature for the treatment of gap non-unions, each having its own limitation. Attempting limb reconstruction in the presence of significant bone loss presents a monumental challenge for the orthopaedic surgeon with no assurance of a satisfactory outcome. Case presentation: An 8-year-old girl attended our OPD presenting an exposed right tibia following a chronic infection to the bone. After debridement of the infected bone, there was an extensive gap between the ends of the tibia. Subsequent to control of all infection, using the Huntington’s procedure; the ipsilateral fibula was medialized to the remaining tibia. This was done in two stages, initially the proximal end of the fibula was fixed to the proximal tibia. After a period of 8 weeks following signs of union, the distal fibula was then transposed to remaining tibia. After a brief period of guarded weight bearing, it was noted that the fibula hypertrophied and was completely incorporated into the tibia. Conclusion: Various methods have been described to manage segmental bone loss of the tibia. The Huntington’s procedure has the advantage that it can be performed by a trained orthopaedic surgeon even in hospitals with modest infrastructure. The Huntington’s procedure is a safe and simple salvage procedure and remains a superb option for treating gap non-unions of the tibia.
Authors and Affiliations
Dr. Tashi Galen Khonglah, Dr. Bhaskar Borgohain, Dr. Wanlamkupar Khongwir, Dr. Kashif A Ahmed
Keywords
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