27709 Osteotomy; tibia and fibula

Name of the Procedure:

Osteotomy; tibia and fibula
Common terms: Bone cutting surgery, Tibial osteotomy, Fibular osteotomy.

Summary

An osteotomy of the tibia and fibula is a surgical procedure where a surgeon cuts and reshapes the bones in the lower leg. This is done to correct deformities, relieve pain, and improve function in the affected leg.

Purpose

This procedure is primarily performed to:

• Correct bone deformities due to conditions like osteoarthritis or trauma.
• Realign and stabilize broken bones.
• Alleviate pain by redistributing weight and pressure on the knee joint.
• Improve the functionality and mobility of the leg.

Indications

• Severe knee pain from arthritis or deformity.
• Angular deformities such as bowlegs or knock-knees.
• Non-healing fractures of the tibia or fibula.
• Age, activity level, and overall health of the patient which make other treatments ineffective.

Preparation

• Fasting for 8-12 hours before surgery.
• Adjusting or stopping certain medications as advised by the doctor.
• Pre-operation assessments including blood tests, X-rays, MRI, or CT scans.
• Planning for post-operative care and mobility aids like crutches.

Procedure Description

1. Anesthesia: General or spinal anesthesia is administered.
2. Incision: An incision is made on the skin over the tibia and fibula.
3. Bone Cutting: The bones are cut and a wedge of bone is either removed or added.
4. Repositioning: The bones are realigned to their new position.
5. Fixation: Plates, screws, or rods are used to stabilize the bones in their new alignment.
6. Closure: The incision is closed with sutures or staples and bandaged.

Duration

Typically, the procedure takes 1.5 to 2 hours.

Setting

This surgery is usually performed in a hospital or specialized surgical center.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Radiology Technicians

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Delayed bone healing or non-union
• Hardware complications (e.g., loosening or breakage)

Benefits

• Pain relief and improved leg function.
• Correction of bone deformities.
• Enhanced ability to perform daily activities.

Recovery

• Initial hospital stay of 2-3 days.
• Use of crutches or a walker for several weeks.
• Physical therapy to restore movement and strength.
• Full recovery commonly takes 3 to 6 months, depending on the extent of surgery and patient health.

Alternatives

• Conservative treatments like physical therapy or bracing.
• Pain management with medication.
• Joint-preservation procedures like knee arthroscopy.
• Total or partial knee replacement for severe cases.

Patient Experience

During the procedure, the patient is under anesthesia and will not feel pain. Post-procedure, they may experience pain and swelling, managed with pain medications. Physical therapy and gradual activity increase are vital for recovery.