Lower limb de-rotational surgery is a procedure aimed at correcting rotational deformities in the legs, commonly caused by conditions such as femoral anteversion, tibial torsion, or rotational malalignment. This surgery helps to improve the alignment of the lower limbs, restoring function and reducing pain.
During lower limb de-rotational surgery, Dr Shales will carefully assess the extent of the rotational deformity and compare to pre-operative imaging studies
Surgery is carried out in the following steps:
1. Incision: Dr Shales will make an incision over the affected area of the leg, exposing the bones and surrounding tissues.
2. Osteotomy: Using specialised instruments, Dr Shales carefully cuts the bone(s) at the appropriate location to correct the rotational deformity.
3. Correction: The bone is then rotated to the desired position to correct the alignment.
4. Fixation: Once the correction is achieved, the bone is stabilised using screws, plates, or rods to maintain the new alignment during the healing process.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.
Before undergoing lower limb de-rotational surgery, patients will typically:
- Meet with Dr Shales for a thorough pre-operative evaluation.
- Undergo pre-operative tests such as blood work and imaging studies.
- Follow any specific instructions provided by the surgical team, which may include fasting before surgery and discontinuing certain medications.
Dr Shales will inform you of any post-operative restrictions. We encourage you to plan ahead for this recovery period in regards to transport, washing, mobilising, etc.
After surgery, patients can expect:
- Pain management to ensure comfort during the initial recovery period.
- Mobilisation with the help of crutches or a walker to assist with weight-bearing as advised by Dr Shales.
- Physiotherapy to regain strength, flexibility, and mobility.
- Follow-up appointments with the surgeon to monitor healing progress and address any concerns.
Rehabilitation following lower limb de-rotational surgery is crucial for optimising outcomes. This typically includes:
- Gradual progression of weight-bearing activities under the guidance of a physiotherapist.
- Range of motion exercises to promote flexibility and prevent stiffness.
- Strengthening exercises to improve muscle function and stability around the corrected joint(s).
- Education on proper body mechanics and activity modification to prevent recurrence of deformity.
While lower limb de-rotational surgery is generally safe, potential risks and complications may include:
- Infection
- Bleeding
- Nerve or blood vessel injury
- Non-union or malunion of the bone
- Persistent pain or stiffness
- Deep vein thrombosis (blood clots)
- Under or Over-correction
The outcomes of lower limb de-rotational surgery can vary depending on factors such as the severity of the deformity, patient compliance with rehabilitation, and any underlying medical conditions. However, many patients experience significant improvement in function, pain relief, and overall quality of life following surgery.
Lower limb de-rotational surgery is a valuable intervention for correcting rotational deformities in the legs, restoring alignment, function, and reducing pain. With careful pre-operative planning, skilled surgical technique, and comprehensive rehabilitation, patients can achieve favorable outcomes and return to their desired level of activity.
Here are a number of the questions we often get asked.
Recovery time can vary depending on individual factors, but most patients can expect to resume normal activities within 3 to 6 months following surgery.
In some cases, a brace may be recommended to support the healing process and protect the corrected alignment. Dr Shales will advise you on whether a brace is necessary and for how long.
If the surgery is being performed in a child then we generally recommend the metalwork be removed as ongoing growth and remodelling can incase the metal in some cases. If the surgery has been performed in a patient who has reached skeletal maturity then it does not need to routinely be removed.
