Osteotomy

The osteotomy ( from Greek ὀστέον " bone " and τομή "cut" ) refers to a in surgery Applied surgical procedure in which one or more bones are deliberately severed for example, misalignments as unphysiological leg axes (O- or X - legs) or to correct clicky hips. Accordingly, it is then often spoken of on conversion or Corrective osteotomy. Osteotomy follows then usually osteosynthesis, often designed as plate osteosynthesis, in order to fix the severed bone portions in the desired position.

In addition, find osteotomies in many other areas of application, such as in dental surgery as Kieferosteotomie (conversion of the jaw bone ).

Often osteotomies are also required to obtain an operational access to deeper organs. This concerns about the osteotomy of the sternum or ribs for heart surgery or lung surgery. In orthopedics, the osteotomy of the medial malleolus is known to have better access to the anklebone, or of the greater trochanter of the thigh, to get a better access to the acetabulum in revision hip replacements especially. Even with osteotomies as part of a surgical approach is finally carried out usually osteosynthesis, designed as cerclage greater trochanter often.

Frequently applied osteotomies

• DVO ( derotation varus osteotomy ): With deformities of the hip joint, which are classified as prearthrotic deformity of the femoral stem is severed below the trochanter or trochanter, a precisely calculated removed wedge of bone at an angle and the femoral neck denoted by an as blade plate, perforated metal rail firmly back with the femur screwed.

• TKO ( head of the tibia osteotomy ): For example, in a varus deformity of the knee joint, the tibia can just below the articular surface of the knee joint is severed from the lateral side and be removed prior to surgery in his angle calculated wedge (closed wedge - surgical technique ), or it is done in the open wedge osteotomy - a are opened osteotomy of the medial ( inside ) without wedge removal, so that a gap remains, but which accrues to the bone healing. In both processes must osteosynthesis, such as a plate fixation, or by means of clips holding two bone fragments stable in the desired position until bone healing. If the lateral part of the knee joint still has no serious wear at a varus gonarthrosis, thus, the prosthetic knee replacement be delayed by a few years or even prevented. Conversely, you can proceed with knock-knee deformity at the tibia even with a valgus deformity of the knee joint, while the open Wegde osteotomy can be done outside or the closed- wedge osteotomy on the inside, also with subsequent stable osteosynthesis.
• Operation by Maquet - Bandi: Some problems with the knee cap sliding bearing can be treated so that the approach of the hamstring chiseled out with a good bone block from the tibia, by the side and is displaced forward and screwed there.
• Near the base of the first Schwenkosteotomie MFK ( metatarsal ): When foot deformities within the meaning of hallux valgus of the first metatarsal bone is cut through grassroots level, fixed after appropriate position correction with a perforated plate or drill wires again.
• Chiari pelvic osteotomy according to: Sometimes the roof of the acetabulum of a hip is not wide enough. The load distribution in the hip joint is then inconvenient to expect premature wear. During the operation the pelvic bone is cut just above the hip joint, the joint swung outward and held the new position with screws or drill wires. The aim is to widen the roof of the acetabulum of the hip.
• Lengthening: Accidents, but also by congenital defects can be considerably a leg shorter than the other. Up to 2 cm difference can be compensated easily by an appropriate shoe dressing. With a difference of 4 cm, it may be useful to extend the affected bone surgery. The most common method is the callus with querer osteotomy or Corticotomie and then slowly pulled apart by distractor. This is followed usually followed by an intramedullary nail or plate fixation, in order to heal the bone once the desired extension distance is reached. Alternatively, use that as slow can be extend telescopically, so the external fixator is also avoided adjustable intramedullary nails. For extensions up to 4 cm and a step-shaped osteotomy is possible with the upper leg split down the middle lengthwise. This is possible especially subtrochantär in the transition between the proximal femur meta - and diaphysis. The necessary extension can be directly set and fixed by means of angle plate osteosynthesis during surgery.
• Zahnosteotomie: method is also applied in the oral surgery, for example, to allow the extraction of wisdom teeth.
• Kieferosteotomie: conversion or relocation of the jaw bone, such as Extension or shortening of the mandible or displacement of the maxilla. See also Chin Wing and Genioplasty
• Femoral neck osteotomy: especially in dogs with hip ailment to Femurkopfresektion, as part of the operation at the onset of a hip prosthesis, in which also the femoral head is resected. The distance of the femoral head can be made independently, for example, in infectious arthritis of the hip, and, prior to the time of the endoprosthesis, the term Girdlestone operation a standard method.
• Laminectomy at the spine ( removal of the vertebral arch with the spinous process of one or more vertebrae)

• Therapeutic procedures in orthopedics and trauma surgery
• Operative treatment procedures
• Therapeutic procedures in veterinary medicine