What is Osteotomy Surgery?
Osteotomy surgery is an operation whereby a bone is cut to shorten, lengthen, or change its alignment. It is sometimes performed on a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is also used to correct a Coxa Vara, Genu Valgum, and Genu Valrum. The operation is done under a general anaesthetic.
Due to the serious nature of osteotomy surgery, recovery times may be extensive. Careful consultation with your consultant is important in order to ensure proper planning during a recovery phase. Tools exist to assist recovering patients who may have non weight-bearing requirements and include bedpans, dressing sticks, long-handled shoe-horns, grabbers/reachers and specialised walkers and wheelchairs.
A Coxa vara is the deformity of the hip, whereby the angle between the ball and the shaft of the femur is reduced. This results in the leg being shortened, and therefore a limp occurs. It is commonly caused by injury, such as a fracture. It can also occur when the bone tissue in the neck of the femur is softer than normal, meaning it bends under the weight of the body. This may either be congenital, also known as Mau-Nilsonne Syndrome, or the result of a bone disorder. Symptoms include pain, stiffness, and difficulty in walking. It is diagnosed by an X-ray. In most cases Osteotomy surgery can ease the condition.
Genu valgum is commonly referred to as “knock knees”, a condition where the knees angle in and touch when the legs are straightened. Persons with severe valgus deformities are typically unable to touch their feet together while simultaneously straightening the legs.
Mild genu valgum is relatively common in children up to two years of age, and is often corrected naturally as children grow and develop. However, the condition may continue or worsen with age, particularly when it is the result of a disease, such as rickets or obesity. Idiopathic is the term used to describe genu valgum that is congenital or has no known cause.
Genu valrum or genu varus (Blount’s Disease), commonly referred to as bow-leggedness, is a deformity marked by medial angulation of the leg in relation to the thigh, an outward bowing of the legs, giving the appearance of a bow. It is also known as bandy-leg, bowleg, bow-leg, and tibia vara. Usually there is an outward curvature of both femur and tibia, with at times an interior bend of the latter bone.
What will happen during my osteotomy consultation?
When you meet with your consultant surgeon they’ll ensure that you have the opportunity to ask any questions you may have about your osteotomy, they’ll discuss with you what’ll happen before, during and after the procedure and any pain you might have. Take this time with your consultant surgeon to ensure your mind is put at rest.
How does osteotomy surgery work?
During osteotomy surgery the bones are exposed surgically and divided with a special saw. The cut ends are realigned in the correct position and held with plates and screws or metal rods (intramedullary nails). Patients will often have abnormal anatomy of the hip since birth although they may not be aware of this. The commonest conditions treated are hip dysplasia (shallow hip), Slipped upper femoral epiphysis and subtle abnormalities in the shape of the femur (thigh) bone.
What are the benefits?
If successful these operations can stop hips from becoming arthritic and then needing a hip replacement or resurfacing.
How safe is it?
These procedures are suitable for patients less than 40 years old. Older patients have poorer bone healing and will often progress to arthritis despite osteotomy.