A primer of osteotomy of the weight bearing long bones in children

A. Why Perform An Osteotomy In Childhood or Adolescence? 1. Progressive deformity for which osteotomy is curative. 2. Cosmesis. 3. To prevent the development of late osteoarthritis (unproven). 4. Progressive ligamentous laxity (rare). 5. Functionally limiting deformities (rare). 6. Development of ad...

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Bibliographic Details
Published in:The Iowa orthopaedic journal 1993, Vol.13, p.136-148
Main Author: Dietz, F R
Format: Article
Language:English
Subjects:
Adolescent
Bone Diseases, Developmental - complications
Child
Child, Preschool
Female
Femur - surgery
Humans
Hypophosphatemia, Familial - complications
Joint Deformities, Acquired - etiology
Joint Deformities, Acquired - surgery
Joint Instability - etiology
Joint Instability - surgery
Knee Joint - diagnostic imaging
Male
Middle Aged
Osteoarthritis - etiology
Osteoarthritis - prevention & control
Osteotomy - methods
Radiography
Tibia - surgery
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Summary:A. Why Perform An Osteotomy In Childhood or Adolescence? 1. Progressive deformity for which osteotomy is curative. 2. Cosmesis. 3. To prevent the development of late osteoarthritis (unproven). 4. Progressive ligamentous laxity (rare). 5. Functionally limiting deformities (rare). 6. Development of adaptive joint deformity (rare). B. When To Perform An Osteotomy 1. Immediate correction for progressive deformities or functionally limiting deformities that can not be expected to improve by the natural history of the deformity. 2. Immediate correction if the problems listed under "A" are present such as the development of adaptive joint deformity or progressive ligamentous laxity. 3. If no indication for osteotomy exists except cosmesis, consider delaying correction to avoid the need for repeated osteotomies in disorders for which recurrence is common. C. How To Do The Osteotomies 1. Perform the osteotomy at the level of the deformity when possible. 2. Choose the simplest, safest method that will accomplish specific goals. 3. Complex restoration of perfect mechanical axis and joint alignment may not be necessary. The lesser risks of simpler techniques should be considered. 4. The specific technique chosen will depend on the experience and abilities of the treating physician.
ISSN:1541-5457
1555-1377