The Huntington procedure: Still a reasonable option for large tibial defects in paediatric patients

Gupta, Shivali; Garg, Gaurav

doi:10.1007/s11832-014-0618-8

Cited by 15 publications

(16 citation statements)

References 21 publications

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“…Manuka honey is effective for treating sore throat with its anti-inflammatory, antiviral, and antifungal properties. Honey coats the inner lining of the throat and destroys the harmful microbes while simultaneously soothing the throat [62, 63]. …”

Section: Health Benefits Of Honeymentioning

confidence: 99%

Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Rao

Sammugam

Ramesh

et al. 2017

Oxidative Medicine and Cellular Longevity

616

471

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Background There are several health benefits that honeybee products such as honey, propolis, and royal jelly claim toward various types of diseases in addition to being food. Scope and Approach In this paper, the effects of honey, propolis, and royal jelly on different metabolic diseases, cancers, and other diseases have been reviewed. The modes of actions of these products have also been illustrated for purposes of better understanding. Key Findings and Conclusions An overview of honey, propolis, and royal jelly and their biological potentials was highlighted. The potential health benefits of honey, such as microbial inhibition, wound healing, and its effects on other diseases, are described. Propolis has been reported to have various health benefits related to gastrointestinal disorders, allergies, and gynecological, oral, and dermatological problems. Royal jelly is well known for its protective effects on reproductive health, neurodegenerative disorders, wound healing, and aging. Nevertheless, the exact mechanisms of action of honey, propolis, and royal jelly on the abovementioned diseases and activities have not been not fully elucidated, and further research is warranted to explain their exact contributions.

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Section: Health Benefits Of Honeymentioning

confidence: 99%

Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Rao

Sammugam

Ramesh

et al. 2017

Oxidative Medicine and Cellular Longevity

616

471

View full text Add to dashboard Cite

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“…Chacha et al 5 described this approach in 1981; in their report, it was successful in 10 out of 11 patients with large tibial defects and sepsis. The use of this approach in children has also been reported by Gupta and Garg 6. In their series of 14 children, successful outcomes were obtained in 13 patients, with mean union time of 13 weeks.…”

Section: Discussionmentioning

confidence: 61%

“…Extreme care should be taken to maintain as much of the periosteal blood supply as possible while mobilising the fibular segment. The vascular supply to the fibula must be preserved6 while performing a limited release of flexor hallucis longus and the interosseous membrane proximally and distally to allow centralisation. Osteotomies are performed with Rongeur bone nibblers, with a limited release being sufficient as the graft is brought medially towards the tibia.…”

Section: Discussionmentioning

confidence: 99%

Ipsilateral fibular transfer as a salvage procedure for large traumatic tibial defects in children in an austere environment

Keenan

Tubb

et al. 2016

J R Army Med Corps

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Large tibial defects present a challenging scenario for the orthopaedic surgeon, particularly in the paediatric patient. Most management options, such as the vascularised fibular graft or Ilizarov technique, require microsurgical techniques or specialist equipment. In an austere environment, acute shortening or limb amputation may be most appropriate. However, limb salvage may be achieved by ipsilateral fibular transfer. In a one-stage operation, the fibular graft is harvested and either placed in the tibial defect in an intramedullary position or secured to the tibia with screws. We present two paediatric cases where this approach was used to preserve the lower limb despite extensive explosive trauma. In the first case, an 11 cm tibial defect was managed with an ipsilateral fibular graft. The graft was placed in an intercalary position proximally, with medial displacement of the ankle and fixation of the fibula as a strut graft. In the second case, a 10 cm tibial defect was managed with an ipsilateral fibular graft, using intercalary placement proximally and distally. Both children returned to weight bearing with crutches within several months of surgery. For large tibial defects, ipsilateral fibular transfer is an effective one-stage operation that represents a viable alternative to amputation in austere environments.

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“…Som P Gupta et al used Huntington procedure to manage large bone defects in children and evaluated final outcome using identical parameters. 25…”

Section: Methodsmentioning

confidence: 99%

Role of Huntington procedure as a limb salvage surgery for complex gap nonunion of tibia in children

Khan

Siddiqui

Julfiqar

et al. 2021

Journal of Clinical Orthopaedics and Trauma

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Back ground: Complex gap nonunion of tibia following open fractures and osteomyelitis with pathological fractures in children is a treatment challenge with unpredictable outcome. Treatment options available are bone transport, bone grafting, induced membrane technique, allograft reconstruction and Huntington procedure (ipsilateral transposition of vascularized fibula). There is no consensus in the literature about which technique is optimal in the given situation. The purpose of the present study is to evaluate the role of Huntington procedure in the management of complex gap nonunion of tibia in paediatric patients. Material and method: Eighteen patients (11 males and 7 females) with a mean age of 8.4 years (range 3 e12 years) having complex gap nonunion of tibia with an average bone defect of 6.6 cm (range 5e17 cm) were treated with Huntington procedure between June 2008 to December 2016. The mean follow-up was 4.3years (range 3.5e6 years). Result: Union was seen in all except one, with an average time to union being 11.5 weeks and13.8 weeks at proximal and distal tibio-fibular synostosis respectively. Revision plating was done in one patient with nonunion. Hypertrophy of fibula was seen in all patients. One patient developed 15 ankle varus and required corrective osteotomy. Ankle was fixed in equinus in three patients with a mean value of 13.3 (range 5 e25 ). Lambrinaudi procedure was done to correct 25 fixed ankle equinus in one patient. Fixed flexion deformity of knee was seen in nine patients with a mean value of 9.7 (range 5 e20 ). Two patients had iatrogenic foot drop; one recovered completely and one had only partial recovery. Shortening was seen in eight patients with a mean value of 3.5 cm (range 1e5 cm). At final evaluation 9 patients were very satisfied, 8 satisfied and 1 was dissatisfied. Conclusion: Huntington procedure is a useful limb salvage surgery for complex gap nonunion of tibia in children. However; further improvements in the surgical technique are needed to increase the patient satisfaction by reducing the risk of complications.

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The Huntington procedure: Still a reasonable option for large tibial defects in paediatric patients

Cited by 15 publications

References 21 publications

Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits

Ipsilateral fibular transfer as a salvage procedure for large traumatic tibial defects in children in an austere environment

Role of Huntington procedure as a limb salvage surgery for complex gap nonunion of tibia in children

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