Agarwal Pawan, Savant Rajiv, Sharma Dhananjaya
Plastic Surgery Unit, NSCB Government Medical College, Jabalpur, MP, 482003, India.
Jamdar Hospital, Gole Bazar, Jabalpur, MP, 482002, India.
J Clin Orthop Trauma. 2019 Nov-Dec;10(6):1128-1131. doi: 10.1016/j.jcot.2019.06.011. Epub 2019 Jun 13.
Management of gap nonunion of tibia is difficult for the surgeons, and time consuming for patients with unpredictable results. There are various methods to treat gap nonunion, but each one has its own limitations. We report the outcomes of ipsilateral fibular transposition (Huntington's procedure) for reconstruction of major tibial defects.
It is a retrospective study including 4 patients who underwent ipsilateral vascularized transposition of fibula for gap nonunion of tibia. Fibula was transferred to tibia as vascularized pedicle graft in one-staged procedure.
Single stage fibular transposition was performed in four patients The transferred fibula united in all patients. Mean follow-up after fibular transposition was 1.2 years. Partial weight bearing started after an average of 5.25 months till hypertrophy of fibula is seen on radiographs than full weight bearing started. The mean time to healing was 7.5 months (range: 5-10 months). Tibialization of fibula occurred in all patients as evident on radiographs.
Huntington procedure is a simple and technically easy for large tibial defects. It does not require microsurgical skill and implants. The union of transferred fibula is faster than conventional graft as it is a vascularized graft. It is a rational choice for the treatment of large tibial defects in selected cases.
胫骨骨不连的治疗对外科医生来说颇具难度，对患者而言耗时且结果难以预测。治疗骨不连有多种方法，但每种方法都有其局限性。我们报告了同侧腓骨移位术（亨廷顿手术）治疗胫骨大段骨缺损的结果。
这是一项回顾性研究，纳入了4例行同侧带血管腓骨移位术治疗胫骨骨不连的患者。腓骨作为带血管蒂移植物一期转移至胫骨。
4例患者均接受了一期腓骨移位术。所有患者移植的腓骨均愈合。腓骨移位术后平均随访1.2年。平均5.25个月后开始部分负重，直至X线片显示腓骨肥大后开始完全负重。平均愈合时间为7.5个月（范围：5 - 10个月）。X线片显示所有患者均出现了腓骨胫骨化。
亨廷顿手术治疗胫骨大段骨缺损简单且技术上易于操作。它不需要显微外科技术和植入物。由于移植的腓骨是带血管的移植物，其愈合速度比传统移植物更快。在特定病例中，它是治疗胫骨大段骨缺损的合理选择。
