Femoral derotation osteotomy

Introduction:

Children with conditions that affect movement, like cerebral palsy, can walk with their legs turned inwards.

A femoral derotation osteotomy is a surgery used to turn the legs out into a correct position, which makes walking more manageable and more comfortable.

Before your child has a femoral derotation osteotomy, it is important to:

• make sure your child’s therapists know about the upcoming procedure
• contact your local physiotherapist or occupational therapist to go on their waitlist for an appointment after surgery
• let your child’s school know about the procedure and that they may be off school for several weeks 
• arrange time off for yourself around the surgery date and let family and friends know so they can provide some support if needed
• let the hospital know as soon as possible if your child becomes sick before their procedure date, as it may need to be rescheduled.

Your child will be under a general anaesthetic for the operation. This means they will be asleep.

In the femoral derotation osteotomy:

1. the thigh bone is cut through at its upper end
2. the bone is turned so that the knee faces forward when walking
3. plates and screws are inserted to hold the bone in its new position.

The plates and screws can be removed after the bone is healed, which can be about 2 years.

The procedure can be done on one or both legs if needed.

Your child will be given pain medication when they wake up from surgery, and they will need to stay in the hospital for 5-7 days, depending on how they recover.

Your child may be able to hold their body weight, or they may need to rest and use equipment for movement while their bones heal. This will depend on the surgeon, the strength of your child’s bones and whether any other procedures were done at the same time.

A knee brace can be worn after surgery to stabilise the leg and make it more comfortable when moving. The brace must be removed several times daily to check the skin for pressure injuries, which are sores that can develop on the skin. 

Caring for your child at home

Your child might need to use equipment to help with movement and everyday activities while they recover. Equipment can include a wheelchair and a commode, a special chair that makes toileting and showering easier. Your child will see an occupational therapist who will help you organise equipment.

Your child’s physiotherapist and occupational therapist will help your child to start walking again and will give them some exercises to do at home.

The hospital will make sure you have pain medicine and instructions for your child when you take them home from the hospital. It is important to follow the pain medication instructions carefully, giving them before moving from one position to another, showering and toileting.

Check your child’s skin regularly for redness and pain. These are pressure areas that can develop into sores. Pressure sores or injuries are severe if left untreated.