Osteotomy - a surgical procedure in which bone dissection is carried out. It is used, for example, in the treatment of osteoarthritis
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or other types of arthritis, in cases when using other methods of treatment fails to relieve pain and restore function of damaged joint.
The whole operation usually lasts 60 to 90 minutes. It can be performed under local or general anesthesia (in most cases, however, a general anesthetic). After induction of anesthesia leg treated with an antibacterial solution. The surgeon determines the exact size of the bone fragments, which he will remove with the help of X-ray, CT or three-dimensional computer modeling.
During the osteotomy, the surgeon removes part of the bone adjacent to the diseased joint. The result should be a displacement of the load region where cartilage is damaged, the one where there are more healthy cartilage.
Typically, osteoarthritis most significantly damaged cartilage in the inner part of the knee. The surgeon removes the fragment of the tibia with its outer side, whereby a large part of the person's weight during movement will move the outer side of the knee joint.
As a rule, suitable patients for osteotomy considered people under the age of sixty years, are overweight and maintain a certain level of physical activity. In addition, damage to the cartilage tissue in the joint should be uneven. Before the surgery, the doctor must make sure that the deformation of the joint is subject to correction. Finally, the osteotomy may be performed only in the absence of any signs of inflammation.
Advantages and disadvantages
The unquestionable advantages of osteotomy is the fact that the operation greatly reduces the pain and may slow the progression of osteoarthritis.
However, due to the joint operation may appear asymmetrically. In addition, if the patient ever need complete replacement of the joint to hold it after the osteotomy will be much more difficult than under normal conditions.
Recovery from an osteotomy
Depending on the complexity of the operation and the patient's overall health, for one to three months may be necessary to use crutches. Sometimes for four to eight weeks after the osteotomy also have to wear a bandage. Physiotherapy and regular walking is an important part of rehabilitation. Full return to normal life can take a long time - from three to six months to a year.
What is osteotomy, indications and contraindications for its implementation
Osteotomy - a dissection of bone orthopedic surgery. The operation is performed under general anesthesia. With the surgical instrument, ultrasound, laser or radio frequency energy produces dissection of bone. After osteotomy bone fixed in the new position with the help of various accessories: nails, plates, bone grafts, special devices, casts, skeletal traction (steel needle is inserted into the bone, and it is suspended from the load - it gradually pulls the bone and puts it in the correct position) .
The indications for osteotomy are:
- congenital and acquired deformities (affecting the shape) of bones, mostly long bone (femur, tibia bone, shoulder, etc.);
- connective tissue (fibrosis) and bony fusion of the joints, which violate their work (ankylosis);
- congenital hip dislocation and its consequences;
- and other congenital metabolic diseases of bones.
Contraindications osteotomy:
- purulent diseases of any organ or tissue;
- any acute illness and exacerbation of chronic diseases;
- severe diseases of the internal organs, particularly the cardiovascular system, kidneys and liver.
Types osteotomy
Osteotomy can be open and closed. When you make the closed osteotomy skin incision length of 2-3 cm, after which the cutting tool is fed to the bone, cross it ¾ of the diameter, and the remaining portion of the bone breaking. This operation is less traumatic than open, but carries a risk of injury of large vessels and nerves.
Open osteotomy is used more often at the same skin incision produce up to 10 - 12 cm, exposing the bone, the periosteum is separated from the bones of a special tool, a bone placed elevators (tools for dissection of the bone), and under the control of the eye produce the intersection of bones. Sometimes osteotomy plane future produce thin drill holes in the bone and through a bone dissected. This technique makes it possible to carry out exactly the intended osteotomy plane.
The shape of the bones used a linear incision (transverse or oblique) and figured (angular, stepped, graduate, flute) osteotomy. When excision of a wedge of bone wedge osteotomy say. Segmental osteotomy called bone dissection at several levels.
In all the goals of the operation are divided into the osteotomy and corrective osteotomy for supporting. Examples of corrective osteotomy may be an osteotomy to correct bone deformation in the wrong accrete fracture and osteotomy for lengthening bones. Osteotomy for supporting held with congenital hip dislocation
Hip dislocation - the result of indirect injury
. But most of the osteotomy performs both tasks: correct bone deformities or wrong position and provides support.
Finally, the osteotomy can be independent operation or just a step some other operation. In individual bones and joints using various modifications of the osteotomy, the most suitable and intended specifically for these parts of the musculoskeletal system.
Complications after osteotomy
Operation osteotomy is not new, for it has developed numerous techniques, each with its own risks of those or other complications. But the complications of today are rare and are not dangerous to the life of the patient. Nevertheless, any, even the most minor operation - it is a source of increased danger, because there is significant not only skill and professionalism of the surgeon, but also the condition of the patient, his individual characteristics and heredity.
Osteotomy can be complicated:
- suppuration of postoperative wound (therefore of great importance in immunocompromised patients);
- displacement of bone fragments (in this case, surgery is required to restore their position);
- delayed union bone (usually depends on the individual characteristics of the organism or metabolic disorders);
- formation of a false joint
False joints - when the mobility of broken bones
- Persistent breach of continuity and mobility of bone, not characteristic of the department, which often occurs after a traumatic fractures and various operations on the bones; in this case required reoperation.
Osteotomy is best done after previous strengthening immunity
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- It will be possible for the prevention of complications and create favorable conditions for the right seam bone.
Galina Romanenko
