Osteotomy, femur, shaft or supracondylar; with fixation
CPT4 code
Name of the Procedure:
Osteotomy, femur, shaft or supracondylar; with fixation
Common name(s): Femoral Osteotomy, Supracondylar Osteotomy
Summary
An osteotomy of the femur (thigh bone) involves cutting and realigning the bone to correct deformities or to alleviate pain from arthritis or other medical conditions. This procedure includes the use of fixation devices (such as plates, screws, or rods) to stabilize the bone as it heals.
Purpose
Medical Condition or Problem it Addresses:
- Corrects bone deformities in the femur.
- Alleviates pain from arthritis or bone misalignment.
- Improves functionality and movement.
Goals or Expected Outcomes:
- Realignment of the femur for better alignment and load distribution.
- Pain reduction and improved mobility.
- Enhanced quality of life and activity levels.
Indications
Symptoms or Conditions Warranting the Procedure:
- Significant deformities or angular malalignment of the femur.
- Severe pain due to osteoarthritis or other joint diseases.
- Reduced function or mobility that impacts daily activities.
Patient Criteria or Factors Making the Procedure Appropriate:
- Patients with persistent pain not responsive to conservative treatments.
- Individuals with significant functional limitations.
- Patients in generally good health to tolerate surgery and recovery.
Preparation
Pre-procedure Instructions:
- Fasting typically required from midnight before the surgery.
- Temporary cessation of certain medications (e.g., blood thinners).
- Arrangements for postoperative care and transportation.
Diagnostic Tests or Assessments Required:
- Preoperative X-rays or CT scans to plan the osteotomy.
- Blood tests and a general health assessment.
- Potential consults with anesthesia and other specialty teams.
Procedure Description
Step-by-Step Explanation:
- Anesthesia: Patient is given general anesthesia for complete sedation.
- Incision: A surgical incision is made over the femur.
- Bone Cutting: A precise cut is made in the bone (osteotomy).
- Realignment: The bone is realigned to its correct position.
- Fixation: Metal hardware (plates, screws, rods) is used to hold the bone in the new alignment.
- Closure: The incision is closed with sutures or staples.
Tools, Equipment, Technology Used:
- Surgical saw, fixation plates, screws, rods, radiographic imaging for guidance.
Anesthesia Details:
- General anesthesia to ensure the patient is asleep and pain-free during the procedure.
Duration
Typical Duration:
- Approximately 2 to 3 hours.
Setting
Location Performed:
- Hospital operating room or a specialized surgical center.
Personnel
Healthcare Professionals Involved:
- Orthopedic surgeon.
- Anesthesiologist.
- Surgical nurses and technicians.
- Radiology technician (if intraoperative imaging is used).
Risks and Complications
Common Risks:
- Infection at the surgical site.
- Blood loss and need for transfusion.
Blood clots.
Rare Complications:
- Nerve or blood vessel damage.
- Delayed or non-union of the bone.
- Hardware irritation or failure.
Deep vein thrombosis (DVT).
Possible Complications and Management:
- Infection managed with antibiotics or additional surgery.
Blood clots managed with medications and physical activity.
Benefits
Expected Benefits:
- Pain relief and improved joint function.
- Correction of bone alignment and leg length discrepancies.
Enhanced ability to perform daily activities and physical movements.
Timescale for Benefits:
Most benefits are realized within 6 to 12 months after procedure.
Recovery
Post-Procedure Care and Instructions:
- Pain management with medications.
- Physical therapy to restore movement and strength.
Use of crutches or walkers as weight-bearing may be restricted initially.
Expected Recovery Time:
Generally, 6 to 12 weeks for initial recovery, with complete healing and function improvement in 6 to 12 months.
Restrictions and Follow-Up Appointments:
- Regular follow-up appointments for X-rays to monitor bone healing.
- Gradual return to activities as permitted by the surgeon.
Alternatives
Other Treatment Options:
- Conservative treatments such as physical therapy, bracing, pain management medications.
Other surgical options like total knee replacement for severe joint arthritis.
Pros and Cons of Alternatives:
- Conservative treatments may offer pain relief but might not correct bone deformity.
- Total knee replacement offers an effective solution for arthritis but is usually considered when joint damage is extensive.
Patient Experience
During Procedure:
Patient will be under general anesthesia and will not experience discomfort.
After Procedure:
- Initial soreness and pain managed by medications.
- Some swelling and bruising expected at the incision site.
- Gradual improvements in pain and mobility as recovery progresses.
- Physical therapy will be critical for optimal recovery and function restoration.