Name of the Procedure:

Osteotomy; Fibula
Common names: Fibular osteotomy

Summary

An osteotomy of the fibula is a surgical procedure where a part of the fibula bone in the lower leg is cut and repositioned or removed. This helps to correct deformities or improve function and alignment of the leg.

Purpose

This procedure addresses conditions like leg deformity, fractures that have healed improperly, or arthritis that affects the alignment of the lower leg. The primary goal is to realign the leg bones to restore proper function, alleviate pain, and improve mobility.

Indications

• Significant leg deformity due to congenital conditions, trauma, or disease.
• Malunion or nonunion of fractures.
• Severe arthritis affecting leg alignment.
• Patients who have not responded to conservative treatments like physical therapy or bracing.

Preparation

• Patients may be instructed to fast for 8-12 hours before the procedure.
• Medication adjustments, especially blood thinners, will be reviewed.
• Pre-operative imaging studies such as X-rays or MRIs to plan the surgery.
• Blood tests and a physical examination to assess overall health.

Procedure Description

1. The patient is given either general anesthesia or regional anesthesia (spinal or epidural).
2. The surgeon makes an incision over the fibula.
3. Specialized surgical tools are used to cut the fibula at the predetermined location.
4. Depending on the underlying issue, the bone section might be repositioned and fixed with plates and screws, or a segment may be removed.
5. The incision is closed with sutures or staples.
6. A cast or brace may be applied to immobilize the leg for healing.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The osteotomy is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve damage
• Poor bone healing or nonunion
• Complications from anesthesia
• Potential need for additional surgeries

Benefits

• Improved leg alignment and function
• Reduction of pain and discomfort
• Enhanced mobility and ability to perform daily activities
• Potentially permanent correction of deformity

Recovery

• Pain management with medications as prescribed by the surgeon.
• Instructions on weight-bearing restrictions and use of assistive devices like crutches.
• Physical therapy may be recommended to aid in recovery.
• Follow-up appointments to monitor healing progress.
• Full recovery and bone healing typically take several months.

Alternatives

• Conservative treatments such as bracing, physical therapy, or orthotics.
• Other surgical options like tibial osteotomy or joint replacement, depending on the specific condition.
• Pros of alternatives: less invasive options may have shorter recovery periods.
• Cons of alternatives: may not provide as definitive or lasting a solution as fibular osteotomy.

Patient Experience

• The patient will be under anesthesia and should not feel pain during the procedure.
• Postoperatively, there may be discomfort and pain managed by medication.
• The patient might experience swelling and bruising around the surgical site.
• Comfort measures include elevation of the leg and ice application to reduce swelling.