CORRECTIVE BONE OPERATION
- Method
- Dividing, realigning and stabilising the bone
- Duration
- about 90 minutes
- Recovery time
- 4 to 6 months
Once growth is almost or fully complete, the leg axis can no longer be guided through the growth plate – the growth that would do the correcting is simply no longer there. The axis is then corrected directly at the bone.
The bone is divided, brought into the desired position and held there with a plate until it has healed. Unlike growth guidance the correction is there immediately – in return the operation is larger and the aftercare longer.
Thigh bone or shin bone?
What matters is where the deformity sits. A full-length standing radiograph shows that and allows the axis to be measured. The correction is made where the deviation arises – otherwise the leg stands straight but the joint sits crooked.
With knock knees the cause usually lies at the lower end of the thigh bone, so the correction is made there. With bow legs it usually sits at the head of the shin bone, that is, below the knee.
In adolescents the procedure is the same as in adults – only the question of timing arises differently. We describe both operations in detail on pages of their own:
Why we wait in adolescents
As long as a growth plate is open, dividing the bone easily injures it – and a damaged growth plate then grows on crookedly. A correction would turn into a new deformity.
So the rule is: as long as enough growth remains, growth guidance is the gentler route. The osteotomy comes afterwards – and then usually only once.
Aftercare following the osteotomy
The bone has to heal, and that takes its time. The aftercare corresponds to that in adults; adolescents usually cope with it faster.
Phase I (0–6 weeks): Partial weight-bearing
- Partial weight-bearing on crutches as prescribed
- Early movement of the knee so that it does not stiffen
- Thrombosis prophylaxis as prescribed
- X-ray check after six weeks
Phase II (6–12 weeks): Building up weight-bearing
- Step-by-step move to full weight-bearing once the bone carries load
- Physiotherapy: gait training, strengthening, mobility
- Cycling and swimming usually possible again
From month 3: Back into sport
- Running and sport as agreed, usually from the fourth month
- Contact sport last of all
- The plate can be removed once healing is complete, but does not have to be
Paediatric and adolescent orthopaedics
Specialist assessment of growth, leg axes and deformities
