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Huntington's procedure revisited.

ABSTRACT: Background: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. Methods: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. Results: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. Conclusions: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.

SUBMITTER: Agarwal P

PROVIDER: S-EPMC6835027 | biostudies-literature | 2019 Nov-Dec

REPOSITORIES: biostudies-literature

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Huntington's procedure revisited.

Agarwal Pawan P Savant Rajiv R Sharma Dhananjaya D

Journal of clinical orthopaedics and trauma 20190613 6

<h4>Background</h4>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.<h4>Methods</h4>It is a retrospective study including 4 patients who underwent ipsilateral vascularized transposition of fibula for gap non ...[more]

PMID: 31708640

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Project description:The possibility of generating neural cells from human bone marrow-derived mesenchymal stem cells by simple in vitro treatments is alluring both conceptually and practically. However, whether phenotypic modulations observed after chemical manipulation of such stem cells truly represent a genuine trans-lineage differentiation remains to be established. We have re-evaluated the effects of a frequently reported biochemical approach, based on treatment with butylated hydroxyanisole and dimethylsulphoxide, to bring about such phenotypic conversion by monitoring the morphological changes induced by the treatment in real time, by analysing the expression of phenotype-specific protein markers and by assessing the modulation of the cells’ transcriptome. Video time-lapse microscopy showed that conversion of mesenchymal stem cells to a neuron-like morphology could be reproduced in normal primary fibroblasts as well as mimicked by addition of drugs eliciting cytoskeletal collapse and disruption of focal adhesion contacts. Analysis of markers revealed that mesenchymal stem cells constitutively expressed multi-lineage traits, including several pertaining to the neural one. However, the applied “neural induction” protocol neither significantly modulated the expression of such markers, nor induced de novo translation of other neural specific proteins. Similarly, global expression profiling of over 21,000 genes demonstrated that gene transcription was poorly affected. Most strikingly, we found that the set of genes whose expression was altered by the inductive treatment did not match the set of genes found to be differentially expressed when comparing untreated mesenchymal stem cells and immature neural tissues. Conversely, by comparing these gene expression profiles with that obtained from comparisons between the same cells and an unrelated non-neural organ, such as liver, we found that the adopted “neural induction” protocol was no more effective in redirecting human mesenchymal stem cells toward a neural phenotype than toward an endodermal hepatic pathway. Keywords: Differentiation analysis

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Huntington's procedure revisited.

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Huntington's procedure revisited.

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