Name of the Procedure:

Osteotomy, femur, shaft or supracondylar; without fixation
Common name(s): Femur osteotomy, osteotomy without fixation

Summary

An osteotomy of the femur involves cutting and realigning the bone in the shaft or near the knee (supracondylar area) to correct deformities. This specific procedure is performed without the use of fixation devices like screws or plates.

Purpose

Medical Condition or Problem:

• Treatment of bone deformities, fractures, or non-unions.
• Correction of improper bone alignment due to congenital issues or trauma.

Goals or Expected Outcomes:

• Improved bone alignment and function.
• Alleviation of pain and improvement in mobility.

Indications

Symptoms or Conditions:

• Severe malalignment or angulation of the femur.
• Persistent pain or functional impairment due to femoral deformities.
• Developmental conditions like rickets or osteogenesis imperfecta.

Patient Criteria:

• Generally healthy individuals who can tolerate surgery and anesthesia.
• Patients with specific bone deformities that demand realignment.
• Patients advised by their orthopedic surgeon that non-fixation is appropriate.

Preparation

Pre-Procedure Instructions:

• Fasting typically required from midnight before the procedure.
• Adjustment or temporary cessation of certain medications as directed by the doctor.
• Smoking cessation to improve healing outcomes.

Diagnostic Tests:

• X-rays or CT scans to assess the specific nature and extent of the deformity.
• Routine preoperative blood tests and anesthetic assessment.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A precise incision is made over the femur at the site of the deformity.
3. Bone Cutting: The femur is carefully cut at the designated area.
4. Repositioning: The bone is realigned to the correct anatomical position.

5. Closure: Once realigned, the incision is closed using sutures or staples.

   Tools and Equipment:

   • Surgical saw, osteotomes, and standard surgical tools.
   • Anesthesia equipment and monitoring devices.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

Performed in a hospital or surgical center in an operating room environment.

Personnel

• Lead surgeon (orthopedic specialist)
• Surgical nurses
• Anesthesiologist
• Surgical assistant

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Pain at the surgical site

Rare Complications:

• Non-union or delayed union of the bone
• Damage to surrounding tissues or nerves
• Anesthetic complications

Management:

• Antibiotics for infection
• Pain management strategies
• Monitoring and management of healing progress

Benefits

Expected Benefits:

• Improved leg alignment and function
• Reduction in pain and discomfort

Timeframe for Benefits:

• Increased mobility and pain relief typically noticed within a few weeks to months post-surgery.

Recovery

Post-Procedure Care:

• Instructions on managing pain and incision care.
• Use of crutches or other assistive devices as the bone heals.
• Physical therapy to regain strength and mobility.
• Regular follow-up appointments for monitoring healing progress.

Recovery Time:

• Initial recovery in a few weeks, with complete healing potentially taking several months.
• Activity restrictions, including weight-bearing limitations, are usually advised during the healing period.

Alternatives

Other Treatment Options:

• Non-surgical management with braces or orthotics.
• Corrective surgery with fixation devices like plates and screws.

Pros and Cons:

• Non-surgical options may be less invasive but less effective for severe deformities.
• Fixation methods provide immediate stability but involve hardware insertion, which could lead to complications like hardware irritation.

Patient Experience

During the Procedure:

• The patient will be under anesthesia and should not feel pain.

  After the Procedure:

• Pain and discomfort managed with medications.
• Instructions provided for wound care and physical limitations.
• Physical therapy to aid in recovery and improve outcomes.

Pain management includes prescribed medications, and healthcare providers will ensure measures for the patient's comfort during the recovery period.