Gap nonunion of tibia treated by Huntington's procedure.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Limb Reconstruction

Background:

• Segmental tibial loss presents a significant reconstructive challenge, often resulting from trauma or infection.
• Traditional treatments for severe tibial defects can be complex and have limited success rates.
• The Huntington's procedure, involving tibialization of the fibula, offers an alternative for limb salvage.

Purpose of the Study:

• To evaluate the mid-term outcomes of the Huntington's procedure for treating segmental tibial defects.
• To assess the efficacy and safety of fibular autografting in restoring tibial continuity.
• To report patient satisfaction and functional recovery following this reconstructive surgery.

Main Methods:

• A retrospective analysis of 22 patients (16-34 years) with tibial defects >6 cm treated with fibular tibialization.
• Procedures were performed in single-stage (15 patients) or two-stage (7 patients) formats.
• Weight-bearing protocols and bracing were implemented post-operatively, with long-term follow-up.

Main Results:

• Fibula hypertrophy observed within the first year, doubling in width by four years.
• Average time to full, unprotected weight-bearing was 16 months.
• High patient satisfaction reported (10 very satisfied, 7 satisfied, 5 fairly satisfied), with one case of persistent nonunion.

Conclusions:

• The Huntington's procedure is a safe and effective salvage option for selected cases of infected tibial nonunion.
• This technique provides a reliable method for restoring tibial continuity and function.
• The procedure demonstrates good mid-term results and patient-reported satisfaction.