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Author Topic: De-roatational osteotomies of femurs & tibias  (Read 843 times)

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Offline salt

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De-roatational osteotomies of femurs & tibias
« on: June 06, 2010, 11:44:42 AM »
My 10 year old son is scheduled for bilateral derotation of femurs, & tibias for miserable malalignment & calcaneal lengthening surgeries on July 12. I was going to have all done at once so he doesn't have to suffer for two surgeries but am concerned about infection spreading through both limbs if the complication arises. He is chronically ill & weak at fighting infections. Was wondering if anyone else had this surgery & what they recommend. My son also has a condition called Malignant Hyperthermia which makes being put under general anesthesia dangerous. Would appreciate chatting with anyone who has undergone these procedures or is a parent of a child who has.

Offline crankerchick

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    • Derotation osteotomy & TTT Post-op diary
Re: De-roatational osteotomies of femurs & tibias
« Reply #1 on: June 07, 2010, 02:34:30 AM »
Hi salt :-)

I'm not 10, and haven't been for about 19 years, but I have had a derotation of my femur and tibia, but just my left leg. I had it done oct 20th of last year. My osteotomy on the femur was just below the hip and the one on the tibia was just below the knee at the tibial tubercle. I also had the tibial tubercle brought down to correct patella alta.

I had internal fixation and was partial weight bearing for 6 weeks. I can't imaging being partial weight bearing on both legs at the same time. At 29, it's kind of hard to tell me to be still or use wheelchair. That said, I can see it being done, you just make adjustments. At 10 years old, 6 weeks is probably an eternity for a kid to not be able to run around, but at least it is all being done at once and only one healing period.

I haven't had any real complications from my surgery. I'm still trying to regain strength and flexibility, but my fracture sites are all healed up and my knee pain is tons better and so far, instability is nonexistent.

I have a post-op diary if it is of any help to you. Here's the link.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline vl7007

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Re: De-roatational osteotomies of femurs & tibias
« Reply #2 on: June 07, 2010, 10:31:10 AM »
Hi salt, welcome to kneegeeks. 

There are a few twisted sisters on this site, my daughter is one of them.  Kat (18 years old) had bi-lateral derotational osteotomies of her tibia/fibula last September (2009), this was done using taylor spatial frixators, and some of the derotation was done during surgery, then the doctors continued turning the bone whilst kat was in hospital, then they operated again to finish off the turning and remove the hardware and insert titanium pins and locking bolts. 

Unfortunately in my daughters case she has a connective tissue disorder that results in her bone continuing to twist, so in February this year, they needed to derotate her left leg again as it had twisted another 20+ degrees in 4 months.  Now it is June and again the left leg is out off alignment so once again kat is requiring further surgery.  This time the doctors will reattach the external taylor spatial frames so they can continue to make adjustments without having to operate.  This is extremely unusual/unique and does not normally happen to people who undergo derotational surgery.  Most of the people I have communicated with on this site that have had derotational surgery have undergone different techniques so their surgery may differ from the style your doctor will do.  Kat also has rotational issues with her femurs however the doctor was not prepared to do both legs top and bottom at once as it is such a big operation.  In her original operation Kat went to theatre at 7am and didn't return until after 10.30pm whi;ch was over 15 hours, subsequent operations were around 7 to 8 hours long. 

Has your ortho surgeon  done bi-lateral femoral/tibal derotations before?  This is very complex surgery, and you need to do all the research you can on the topic.  On the internet look for derotational osteotomies in particular try the hospital sites, Royal Childrens Hosptial Melbourne, shows you what type of hardwear is used and what to expect from pro-op, surgery, and post-op treatment.  You will need to make adjustments in the home as your child will not be able to toilet himself and you will definately need a wheelchair and whairchair commode.  also you will most probably need a hoist depending on how heavy your son is as you will have to lift him  for transfers etc.  Clothes can also be an issue as getting underwear on will be a problem, etc.  You will be under a team of therapists who will have you cope with the challenges ahead. 

Please read my page under spiritual help (I am worried about my daughtes derotational surgery) there you will find some others who have had this surgery, and it may give you some insight on what to expect.  I would be happy to continue talking with you about this or any questions you have.  just let me know and i will send you my email address.

Take care both my daughter and my thoughts are with you.  vicki kats mum