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Concept
Osteotomy
Summary
An osteotomy is a surgical operation whereby a bone is cut to shorten or lengthen it or to change its alignment. It is sometimes performed to correct 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 varum. The operation is done under a general anaesthetic.
Osteotomy is one method to relieve pain of arthritis, especially of the hip and knee. It is being replaced by joint replacement in the older patient.
Due to the serious nature of this procedure, recovery may be extensive. Careful consultation with a physician 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 specialized walkers and wheelchairs.
Two main types of osteotomies are used in the correction of hip dysplasias and deformities to improve alignment/interaction of acetabulum – (socket) – and femoral head (femur head) – (ball), innominate osteotomies and femoral osteotomies. The bones are cut, reshaped or partially removed to realign the load-bearing surfaces of the joint.
Adjustments are made to part of the hip-bone. Many operating methods and variations have been developed. They are defined by the type of cut and adjustment made. Some acetabular procedures are named after the surgeons who first described them as Salter (R. Salter), Dega (W. Dega), Sutherland (D.H. Sutherland), Chiari (K. Chiari): other names one may encounter are Ludlov, P. Pemberton, and James B. Steele. Some are named after the shape of cut (e.g. Chevron, Wedge) or the way the bones are aligned (Dial=old style rotary dial phone).
A femoral derotation osteotomy can be performed to correct version abnormalities such as excessive anteversion or retroversion of the hip joint. Excessive anteversion of the femur results in anterior instability of the hip joint while excessive retroversion results in femoroacetabular hip impingement.
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