The following patient information sheet is meant to help patients and family better understand a specific pediatric orthopaedic condition. It is not meant to be comprehensive, and only reflects one viewpoint. This page does not replace a medical evaluation by a pediatric orthopaedic surgeon, and your own surgeon may have a different approach to your condition.
What is an osteotomy?
Osteotomy means that the bone has been divided into two segments. In general, the bone is either shifted, or a wedge is removed or inserted to change the shape of the bone. It is then held in position with plates and screws, rods, wires and or casts until it heals.
When are osteotomies of the leg necessary?
Osteotomy is necessary when there is deformity in the bone which is functionally significant and which cannot be corrected with natural growth, bracing or surgically guided growth. Osteotomies may be necessary in the femur (thigh bone), tibia and fibula (shin bones) or both.
What can I expect with leg osteotomy surgery?
Incisions will vary depending on the site of the osteotomy. The bone is typically held together either with a plate and screw construct, or a rod within the bone. Oftentimes I will place a temporary device to hold the bone in position during surgery, and there will be small incisions because of this.
If the osteotomy is at the knee I may place a brace, and if the osteotomy is at the ankle I will place a splint. Your child will be instructed to either place no weight or just the weight of the foot when walking for the first 6 to 10 weeks, followed by gradual increases in weight bearing and generally normal walking at 3 to 4 months after surgery.
Occasionally, the anesthesia pain service will offer nerve blocks or an epidural catheter prior to surgery. If this is a possibility, I highly recommend it as it can be very helpful for pain control after surgery.
In general, children are in the hospital for one day after surgery at the ankle, two days after surgery at the knee, and three days after surgery at the hip.
What are the risks of surgery?
Surgeries about the knee can pull on the peroneal nerve. This is the nerve that allow you to pull up your foot. If this occurs then repeat surgery to either reverse the osteotomy or to release pressure on the nerve may be necessary.
Delayed or incomplete healing of the osteotomy is possible but uncommon. If the bone does not adequately heal, then a repeat surgery is necessary to take bone from the pelvis to put into the osteotomy site.
Other nerve and blood vessel injury, joint stiffness, infection and wound issues are all quite uncommon with hip osteotomy surgery but all possible. General anesthesia always carries some risk although complications of anesthesia are also uncommon.