What is an osteotomy?
When is an osteotomy performed?
Osteotomy is used to correct malpositions of bones – and also teeth. Most osteotomies are performed on hip, knee and foot joints. These joints are subjected to particular stress, and unnatural positions of bones in relation to each other can develop over a lifetime due to wear and tear of cartilage. Malpositions can also be congenital.
Osteotomy: Orthopedics
- Osteoarthritis
- bow or knock-knees (varus or valgus deformity)
- Different leg lengths
- Malpositions after bone fractures, for example in the ankle joint or knee
- Bunion (hallux valgus)
Osteotomy: Dental and Maxillofacial Surgery
Teeth that are not in the row of teeth cannot always have their position corrected by braces. If they remain in the jaw, inflammation or damage to neighboring teeth may occur. In such cases, removal of the corresponding tooth or tooth remnant is necessary. Typical dental or oral surgical reasons for osteotomy are:
- Teeth or tooth fragments with an atypical position in the jaws
- Broken teeth after accidents
- Root remnants left in the jaw before dental rehabilitation
What do you do during an osteotomy?
Orthopedic osteotomy of the pelvis
Orthopedic osteotomy of the knee
Orthopedic osteotomy of the foot for bunion.
Various surgical procedures are available for the treatment of bunions: scarf osteotomy, chevron osteotomy, Akin osteotomy and Weil osteotomy. These procedures are also used in combination in many cases, since the crooked toe is often due to various malpositions in the individual toe and foot joints.
The chevron osteotomy follows the same principle, but here the metatarsal bone is sawed through in a v-shape rather than a z-shape.
If the cause of the bunion is an excess length of the metatarsal bone, the Weil osteotomy is recommended. Here, too, the surgeon cuts the metatarsal bone; he then removes a bone disc to shorten the metatarsal bone.
Dental and maxillofacial osteotomy
Teeth consist of three parts: the crown, the neck of the tooth and the root. With the root of the tooth, they are anchored in recesses of the jawbone (dental compartments or alveoli). The gums, as a part of the oral mucosa, cover the tooth necks and roots and the tooth compartments.
Osteotomy in the jaw area can be performed on an outpatient basis and, depending on the extent, under local or general anesthesia.
Once the dentist has loosened the tooth sufficiently, he can lift it out of the tooth pocket using a lever or forceps. He then grinds off sharp bone edges and sutures the gum over the now empty tooth pocket.
What are the risks of osteotomy?
In general, osteotomy involves the following risks, which, however, can generally occur with any operation:
- Bleeding during and after the procedure
- Infections
- @ Injury to nerves, blood vessels and tendons
- Unaesthetic or painful scarring
- Wound healing disorders
Risks of osteotomy in orthopedics
After surgery, the foot often swells and movement of the toes is significantly restricted. Lymphatic drainage is helpful so that the swelling goes down as quickly as possible. Possible complications also include:
- necrosis of the operated bone (death of the cells)
- Slipping or loosening of the inserted screws and plates
- Osteoarthritis
- Renewed displacement of the joint position
- Different leg lengths after osteotomy in the knee and hip region
Risks of osteotomy in dental surgery
In dental and maxillofacial surgery, the following problems may occur during osteotomy:
- Destruction of dental crowns
- Dislocation of the temporomandibular joint
- Swallowing or inhalation of tooth parts
- Lower jaw fracture
- @ Renewed displacement of the joint position
What do I have to consider after an osteotomy?
Orthopedic osteotomy
In case of wound pain in the first days after surgery, the doctor may prescribe an analgesic medication if necessary. The wound dressing will be changed every two days. In addition, your doctor will take x-rays of the operated joint during the first week after the osteotomy and for four weeks afterward to check for proper joint position.
