De correction osteotomy of the lower leg
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2
The
correction osteotomy of the lower leg is performed in patients that
have knee complaints because of wear at the inner side of the knee and are still
too young to get an artificial kneejoint. Because of the wear an ‘’o’’
deformity of the leg has arisen(1).
With
the intervention the “o”deformity is more or less changed to a “x”.
Because of this the inner side of the knee is less stressed at standing and
running. The pain complaints to the inner side of the knee decrease because of
this and the patient can move
better.
In
the Waterland hospital a so-called "open wedge technique" is applied.
To achieve the correction no bonewedge on the outside is removed, but an
artificial bonewedge to the inner side is introduced (2).
The
advantage of this technique is that a much more precise correction can be
achieved and that the tibial bone does not need to be cut.
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A
cut of 10 cm at the front / inner side of the knee is made (3) and the bone
becomes visualised. A thin wire is introduced in the bone to be able to
stipulate the correct direction of the saw cut in the tibial bone. This is
checked with a radioscopy apparatus (4,5). Afterwards the cut in the tibial bone
is made with a special saw(6,7).
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Using
metal wedges the saw cut is opened slowly until the just correction has been
reached (8,9). Afterwards the wedge of artificial bone with the correct
cross-section (10) is placed. After two years this artificial bone will be
replaced by the body with natural bone.
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For
strengthening the bone, a metal plate is introduced that it is fixed with screws
(11-14).
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With
the radioscopy apparatus is checked if a good correction has arisen and if the
metal plate and the screws are correctly positioned (15,16).
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The
wound is closed in several layers. For the skin staples are used (17,18). At
last a slightly oppressive bandage is applied (19).
The
first day after the operation the bandage is removed and the patient is
mobilised and practise with the fysiotherapist is started. During 6 weeks the
patient will use crutches with partial
weight bearing.
After 6 weeks an x- ray is made and in general the weight bearing can then go to full . The total rehabilitation lasts 3 to 6 months.