Osteotomy: Difference between revisions

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=== Hip Osteotomy  ===
=== Hip Osteotomy  ===
It is mainly of 2 types:<br>
#'''INNOMINATE OSTEOTOMIES:''' Osteotomy of the innominate/iliac bone.Following are some of the innominate osteotomies.<br>
'''Salter's osteotomy:''' this is an osteotomy of the iliac bone, above the acetabulum. The roof of the acetabulum i rotated with the fulcrum at the pubic symphysis, so that the acetabulum becomes more horizontal, and thus covers the head.<br>
'''Chiari's pelvic displacement osteotomy:''' The iliac bone is divided almost tranversely immediately above the acetabulum, and the lower fragment is displaced medially. The margin of the upper fragment provides additional depth to the acetabulum.<br>
'''Pemberton's pericapsular osteotomy:''' A curved osteotomy is made. The roof of the acetabulum is deflected downwards over the femoral head, with the fulcrum at the triradiate cartilage of the acetabulum.<br>
2. '''FEMORAL OSTEOTOMIES:''' Osteotomy of femur bone.<br>


= References  =
= References  =

Revision as of 15:04, 29 April 2014

Original Editor Aarti Sareen

Top Contributors - Aarti Sareen, Temi Olagunju, Kim Jackson and George Prudden

Introduction[edit | edit source]

It means the cutting of the a bone. It is a surgical procedure which requires careful planning during recovery period and is done under a general anaesthetic.. The purpose of osteotomy done at different joint is different.[1]

Indications[edit | edit source]

Generally, people who are under 60 years old, active, and overweight are considered appropriate candidates for osteotomy.It is mainly done to:

  • To correct excessive angulation, bowing or rotation of long bones.
  • To correct mal-alignment of a joint due to mal-union or deformity like coxa vara, genu valgum, and genu varum etc.
  • To permit elongation or shortening of a bone in cases of leg lenght inequality.
  • To relieve pain in arthritis, especially of the hip and knee.
  • Special indications where osteotomy is performed for purposes other than above e.g McMurray's osteotomy.

Procedure[edit | edit source]

After anesthesia is administered, which may be regional, or general, the surgical team sterilizes the part with antibacterial solution.
Surgeons map out the exact size of the bone wedge they will remove, either using an X-ray, CT scan, or 3D computer modeling. The surgeon removes a wedge of bone located near the damaged joint. The procedure is supposed to cause a shift of weight from the area where there is cartilage damage to an area where there is more normal or healthy cartilage.The approach is different for different joints.

Ultimately, the procedure allows weight to be distributed more evenly across the joint cartilage. Osteotomy surgically repositions the joint, realigning the mechanical axis away from the damaged cartilage. Once the wedge of bone is removed, the surgeon brings the bones that remain together and uses pins or staples to secure them. An immobilization cast or internal plates are also sometimes used for stability.[2]

Various types                                        
[edit | edit source]

JOINT                                         
OSTEOTOMIES
Jaw
Dentofacial osteotomy or corrective jaw surgery
Chin
Osteotomy of the Chin
Elbow
French Osteotomy
Spine
Spinal osteotomy
Knee
High tibial osteotomy
Hip

McMurry osteotomy, Pauwel's osteotomy, Salter's osteotomy, Chiari's osteotomy, Pemberton's osteotomy



Jaw osteotomy[edit | edit source]

The operation is used to correct jaw problems and dentofacial deformities like maxillary prognathisms, mandibular prognathisms, open bites, difficulty chewing, difficulty swallowing, temporomandibular joint disorder pains, excessive wear of the teeth, and receding chins. Many surgeons prefer this procedure for the correction of a dentofacial deformity due to its effectiveness.

Chin osteotomy[edit | edit source]

Chin osteotomy is  done either to correct a verticle short chin or to shorten a chin.Chin osteotomies (cutting the bone and moving it) are done through an incision inside the mouth. It is technically more difficult than an implant and has more swelling and recovery than a simple chin implant. Also, there is usually temporary loss of feeling of the lip and chin after that takes several weeks to months for full return of sensation.

Elbow osteotomy[edit | edit source]

Spinal osteotomy[edit | edit source]

Knee Osteotomy[edit | edit source]

Hip Osteotomy[edit | edit source]

It is mainly of 2 types:

  1. INNOMINATE OSTEOTOMIES: Osteotomy of the innominate/iliac bone.Following are some of the innominate osteotomies.

Salter's osteotomy: this is an osteotomy of the iliac bone, above the acetabulum. The roof of the acetabulum i rotated with the fulcrum at the pubic symphysis, so that the acetabulum becomes more horizontal, and thus covers the head.

Chiari's pelvic displacement osteotomy: The iliac bone is divided almost tranversely immediately above the acetabulum, and the lower fragment is displaced medially. The margin of the upper fragment provides additional depth to the acetabulum.

Pemberton's pericapsular osteotomy: A curved osteotomy is made. The roof of the acetabulum is deflected downwards over the femoral head, with the fulcrum at the triradiate cartilage of the acetabulum.

2. FEMORAL OSTEOTOMIES: Osteotomy of femur bone.

References[edit | edit source]

  1. J Maheshwari. Essential Orthopaedics. 2nd revised and enlarged edition. Interprint publication.New Delhi.
  2. Eustice C.webpage updated on March 26, 2012, http://osteoarthritis.about.com/od/osteoarthritistreatments/a/osteotomy.htm

[[Category:Medical]