Lower Femoral Osteotomy Surgery In India At Affordable Low Cost

Overview

Osteotomy

An Osteotomy, of any kind, is an operation where a bone is cut, usually realigned in some way, and then re-fixed to heal in its new configuration.

The Femoral Osteotomies described in this section are, as the name suggests, osteotomies carried out on the Femur (thigh bone) to correct a number of conditions. Some operations are specifically named, others are referred to by the condition they fix, such as S.U.F.E. (Slipped Upper Femoral Epiphysis).....

Rotation Osteotomy

The most common problem requiring a femoral osteotomy is where the femur is abnormally twisted causing the foot to be turned either inwards or outwards. This "abnormal anteversion" is corrected by a rotation osteotomy, guided for precision by pre-operative CT scans. The femur is cut, rotated to the correct angle, then fixed in place with plates and screws. After a year the bone will have healed, and the plate and screws are removed.....

Varus Osteotomy of the Femur

Varus osteotomy of the femur is an operation where the shaft of the femur is divided just below the neck. The angle between the neck and the shaft is reduced and this can produce better cover of the most deformable part of the femoral head, so encouraging circular remodelling of the area affected by Perthes' disease.....

Valgus Osteotomy

In some children, whose femoral head is not sufficiently round and where it will not centre deeply in the socket in abduction (outward movement of the leg), varus osteotomy is inappropriate, as is pelvic osteotomy. In these patients where movement is limited and where the surgeon appreciates that the remodelled head will be significantly out of round, a valgus osteotomy can restore movement, restore leg length and generally improve the function of the hip....

Complex Procedures

Occasionally patients present where there is a very complex abnormality of the proximal femur with a very short neck, a very high trochanter and such disorganisation that none of the other operations described would provide for a restoration of normal anatomy.....

Treating Slipped Upper Femoral Epiphysis - S.U.F.E.

This condition affects the young while their bones are still growing. It occurs where the growth plate at the upper end of the femur de-couples and the head of the femur slips backwards and downwards. The leg tends to be in a position of external rotation (particularly when sitting).

The vast majority of cases can be treated successfully in the first instance by passing a single threaded screw across the growth plate to prevent further slippage, and to encourage fusion of the growth plate......

Residual deformity following slipped upper femoral epiphysis

Patients who still have significant bony deformity at 18 months and more after the initial presentation, may like to consider a reconstructive operation of the upper end of the femur.

This is a complex operation (Imhauser's, published in Germany in 1977). It involves insertion of a blade plate along the track of the neck of the femur, reaching across the growth plate in some circumstances....

Rehabilitation After a Femoral Osteotomy

Osteotomy of the femur is usually a reasonably stable operation and partial weightbearing is usually possible, and to be encouraged, in the immediate aftermath of the operation. It is important, particularly for teenagers (where in one year there was a 35% re-operation rate), to realise that although the plates used give the impression of great structural strength, they are not capable of taking much more than half body weight without risk of bending, breaking or the screws being pulled out....

Following a femoral osteotomy alone, the vast majority of patients will be fully rehabilitated within six months....

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