Skip to main content

TORSIONAL OSTEOTOMY FOR A ROTATIONAL DEFORMITY OF THE LEG AXIS

Method
Correction of torsional deformities of the femur or tibia
Duration
90-120 minutes
Recovery time
4-6 months

Torsional osteotomies are specialised procedures for correcting rotational deformities of the thigh bone (femur) or the shin bone (tibia) that can lead to a deviation of the axis, to chronic instability of the kneecap or to pain. Excessive internal or external torsion in particular can severely impair the normal play of the joint and the way the kneecap runs.

These are often congenital or developmental deformities that show themselves clinically in a changed gait (for instance an in-toeing gait), in instability or in pain. Precise imaging with a 3D CT scan allows the angle of torsion to be determined exactly.

What is a torsional osteotomy?

The torsional osteotomy is carried out at the lower femur or the upper tibia, depending on where the deformity lies. Under fluoroscopic control the bone is divided, rotated into the desired alignment and fixed with a locking plate. The exact rotational correction is determined by planning beforehand.

The operation is carried out under general anaesthetic. Depending on the extent of the correction and the stability of the fixation, mobilisation with partial weight-bearing can begin early. In certain cases the osteotomy is combined with a correction of the leg axis or an MPFL reconstruction.

Rehabilitation after a torsional osteotomy

Aftercare following a torsional osteotomy requires movement and load-bearing capacity to be restored step by step. Structured physiotherapy is essential.

Phase I (0-6 weeks): protection and mobilisation
  • Partial weight-bearing with forearm crutches (about 15-20 kg)
  • Cooling, lymphatic drainage, pain management
  • Passive mobilisation exercises (CPM), early activation of the quadriceps
Phase II (6-12 weeks): building up load
  • Progression to full weight-bearing where the bone is healing well
  • Active movement, muscle-building programmes
  • Co-ordination and stability training
Phase III (from week 12): functional integration
  • Sport-specific training (for instance running training)
  • Return to recreational or occupational sport
  • Return to full capacity after individual assessment