Leg straightening for adults
If a straightening of the leg is carried out in adults, this is done surgically. Conservative methods can do little for the adult, as growth is already complete. At most, one can treat the deformity symptomatically or try to prevent it from worsening.
Symptomatic therapy includes pain medication and physiotherapy to stabilize the knee joint. With insoles for the shoes, which are made to fit exactly, one can try to compensate for a knee-lower foot and prevent the resulting further deterioration of the malposition. The operation is called repositioning osteotomy.
Before the operation, a reliable diagnosis must be made. For this purpose the legs are first inspected. If there is a pronounced x- or bow leg position, this is usually clearly visible.
Then the legs are x-rayed and the carrying axis of each leg is determined and measured. In such a case, X-rays are always taken in a standing position so that the doctor can see how the axis of the legs behaves under the load of the body weight. The operation of the leg malposition depends on whether bow legs or knock-knees are present and is performed in the clinic under general anaesthesia.
The procedure is based on an axis correction by removing pieces of bone. These vary in size depending on the degree of malalignment and are removed in different places depending on whether knock-knees or bow legs are present. The bones are then fixed with plates, nails and screws.
As with any operation, straightening of the leg involves certain risks and side effects. These include the side effects triggered by the anaesthetic, such as nausea, vomiting and, in older patients, confusion (continuity syndrome). Later, there may be wound healing problems, scarring or wound infections at the surgical suture.
Leg straightening for knock knees
X-leg straightenings are rarely performed and are among the more difficult operations. They are performed on the thigh, directly above the knee. The bone is sawn in and thus straightened. The gap is then held in shape with a system of angle-stable plates. During the operation the position of the cut and the fit of the plates are checked by constant X-ray control.
Leg straightening for bow legs
For the correction of bow legs, which are performed much more often than a correction of knock-knees, the “closed wedge” technique is usually used. Here a wedge-shaped piece of bone is sawn out of the shin. The two newly formed bone ends are then brought closer together and fixed with plates.
In addition to the “closed wedge” technique, there is also the “open wedge” technique. This technique is similar to the closed wedge technique in that the stabilization is also carried out with stable-angle plates. However, the ends of the bones are not brought closer together, but are filled with bone material from the iliac crest depending on the size of the resulting gap.
This operation, like the straightening of bow legs, is also carried out under strict X-ray control. The hospital stay after correction of a leg malposition lasts 4 to 7 days without complications. In the first few weeks after an operation to straighten the leg, the legs should be spared as far as possible.
Forearm crutches to relieve the legs can usually be dispensed with after about 6 weeks. Useful supplements are treatment methods such as physiotherapy, cold therapy and lymph drainage. These treatments are best carried out 2 times a week.
In order not to put too much strain directly on the operated legs, one should refrain from sports for the time being. Particularly affected are sports that put a lot of strain on the joints, such as jogging. Sports that are easy on the joints, such as water gymnastics, swimming or cycling, can be resumed quite early.
