Adjustment osteotomy of the toes

Correction of the axes of the toes is frequently performed. The reason is usually so-called hammer toes (hallux valgus), which cause a c-shaped deformation of the big toe. Reasons are often shoes worn too small in childhood.

Patients with advanced hallux valgus usually complain of instability in the entire foot when walking, and also of pain when moving. These are caused by the fact that a defective position in a joint is always associated with arthrotic wear and tear. Cosmetic reasons also often contribute to the decision to have a repositioning osteotomy of the foot toe.

During the operation, which is performed under general anesthesia, the two bones of the toe are separated at the site of the connecting joint. In the course of time and the progression of the malpositioning, the ends of the bones have adapted to the malpositioning and the end edges of the bones have each been “filed” crooked. These skewed areas are straightened with a saw so that the two bones are once again straight.Then the toe is brought back into a straight position.

Wires are inserted to ensure that the new position of the toe is still unstable. The wounds are then closed. The wires are removed after a few weeks when the new bone ends have reattached to the joint.

Adjustment osteotomy of the jaw

The repositioning osteotomy of the jaw is understood to be the surgical alteration of the positional relationship between the lower and upper jaws, whereby either only one part of the jaw (either the lower or upper jaw) is repositioned or positional changes are made to both parts of the jaw. The repositioning osteotomy can always be considered as a surgical-therapeutic procedure if the affected person has a pronounced jaw malposition (dysgnatia; jaw and teeth deviate from the normal position: e.g. open bite, overbite etc. ), which cannot be corrected by conventional orthodontic measures.

The surgical procedure is usually preceded by an orthodontic preparation phase of 6-18 months and the removal of any wisdom teeth that may be present. The repositioning osteotomy itself is performed under general anesthesia and is accompanied by a several-day stay in the ward. In order to change the position of the lower and/or upper jaws, these must first be detached from the facial skull during the operation, and then reattached to the desired position with screws and plates.

After the operation, a further orthodontic treatment phase is usually performed to fine-tune the position of the teeth. In order to finally achieve a permanently secured tooth and jaw position, so-called retainers (wires) are attached to the back of the upper and lower incisors as a last step. The screws and plates are removed in another surgical procedure after the bone has healed.