27475 Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur

Name of the Procedure:

Arrest, epiphyseal, any method (e.g., epiphysiodesis); distal femur

Summary

This procedure involves stopping the growth of the growth plate (epiphysis) in the lower end of the femur (thigh bone). It can be performed using various methods to address issues such as unequal leg length.

Purpose

The procedure targets conditions like leg length discrepancy, where one leg is shorter than the other. The goal is to halt growth in the longer leg, allowing the shorter leg to catch up and achieve a more balanced length.

Indications

• Significant leg length discrepancy.
• Growth abnormalities in the femur.
• Conditions such as congenital limb defects or acquired growth disturbances.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Adjustment or cessation of certain medications may be necessary.
• Pre-procedure imaging tests like X-rays to assess bone growth.

Procedure Description

1. The patient is administered general or regional anesthesia.
2. An incision is made near the growth plate of the distal femur.
3. The growth plate is disrupted using surgical tools or other methods as applicable.
4. The incision is closed with sutures or surgical staples.
5. The area is bandaged and monitored post-operation.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

The procedure is performed in a hospital or a surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Infection at the surgical site.
• Damage to nearby structures like nerves or blood vessels.
• Incomplete growth arrest.
• Complications from anesthesia.
• Need for additional surgery.

Benefits

• Correction of leg length discrepancy.
• Improved alignment and gait.
• Potential alleviation of associated pain and discomfort.

Recovery

• Patients may need to use crutches or a walker initially.
• Pain management with prescribed medications.
• Follow-up appointments for monitoring growth and healing.
• Physical therapy might be recommended.
• Full recovery can take several weeks to months.

Alternatives

• Observation and regular monitoring without surgical intervention.
• Shoe lifts to compensate for leg length discrepancy.
• Alternative surgical options like limb lengthening procedures:
  • Pros: Potentially less invasive.
  • Cons: Might not provide a long-term solution.

Patient Experience

• Patients may experience discomfort or pain during the initial recovery period.
• Pain is managed with medications and rest.
• Physical therapy aids in regaining strength and mobility.