Femoral Osteotomy

A femoral osteotomy is most often done in patients who are born with a hip abnormality. In some patients, the pelvic and femur bones may not work together in the right way. The femur may be angled too far forward or backwards. They may walk with inward- or outward-facing toes. The surgery is often performed to delay a joint replacement. Surgery is considered for the below conditions:

• Legs that are of different lengths due to various pathologies
• Nonunion of a femoral neck fracture
• Nonunion or malunion of a hip fracture
• Cerebral palsy: A patient with this condition can have severe muscle spasms that can cause the hips to come out of their sockets.
• Hip osteoarthritis
• Fibrous dysplasia (a condition in which repeated microfractures of the femoral neck lead to progressive displacement and abnormal healing of the femur)
• Femur abnormalities can cause severe pain and mental agony due to the stigma attached to them.

A femoral osteotomy can ease pain in the hip joint, and it can also help an individual run and walk more normally. Moreover, it can correct inward- or outward-facing toes.

Risks of femoral osteotomy are

• Anesthesia risks (headache, nausea, and drowsiness)
• Infection
• Bleeding
• Bone may not heal as it should
• Nerve damage
• Arthritis
• Fracture (broken bone)
• Clots in the deeper veins
• Cartilage degeneration
• Persistence of pain after the surgery

A femoral osteotomy is usually performed under general or spinal anesthesia. The surgery usually takes 90-180 minutes depending upon the cause of the surgery.

• The patient is placed on their back on an operating table. A surgeon administers anesthesia to the patient and monitors his/her vitals throughout the surgery.
• The surgeon makes a cut along the patient’s femur near the hip joint.
• The surgeon uses X-rays to confirm where he/she will cut out a small part of the femur.
• The surgeon cuts the femur using an osteotome.
• The surgeon puts the femur in the right place and turns it to fit as it should into the hip socket.
• The surgeon attaches a plate with screws or pins to the top of the femur. The plate helps align the femur in the hip socket and keeps the bone in place as it heals.
• The surgeon then closes up the incision, and the patient is monitored in the hospital for a few days

The patient should be able to put weight on the leg four to six weeks after the surgery. The patient will require help getting around for a few days. In addition, the patient may be recommended for physical therapy after the surgery. 

In some cases, the metal plate may need to be removed at some point in the future. Within or after six weeks, the patient can start walking without pain and difficulty.