Femoral derotation osteotomy factsheet

Introduction:

Some children have conditions that affect movement and cause them to walk with their legs turned inwards. 

Femoral derotation osteotomy is a procedure that turns the legs out into the correct position, making walking easier and more comfortable. 

 Before the procedure

Your child’s treatment team will let you know if any tests or scans need to be done and whether they need to see a physiotherapist or occupational therapist before the procedure

The hospital will call you before your child’s procedure to let you know:

  • what time you need to arrive
  • when your child needs to stop eating and drinking
  • how long your child may need to stay in the hospital.

You may also want to tell:

  • your child’s school of their surgery
  • your workplace that you may need time off around the surgery
  • friends and family who may be able to help out while your child is recovering.

 During the procedure

Your child will be under a general anaesthetic for the procedure. This means they will be asleep and will not feel any pain. 

In the femoral derotation osteotomy procedure:

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

 After the procedure

After the procedure, your child will be given pain medicine. In hospital, pain management is given through:

  • a nerve block
  • a drip
  • oral medicine.

Your child’s doctor will let you know when they can go home from the hospital. This will depend on: 

  • their recovery 
  • how strong the bone is 
  • whether any other procedures were done at the same time.

Your child’s doctor will let you know when they can put weight on their leg after surgery. They may also need to wear a knee brace after surgery to stabilise the leg and make it more comfortable when moving. 

 Management

Caring for your child 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
  • toileting.

Reposition your child regularly and check the skin for redness and pain, particularly under the knee brace. Pressure injuries can be severe if left untreated.

Your child might need equipment to help with movement and everyday activities while recovering. Equipment can include: 

  • wheelchair 
  • a commode - a special chair that makes toileting and showering easier. 

Your child will see an occupational therapist (OT) who will help you organise equipment. An OT or physiotherapist can also help your child with:

  • using equipment
  • moving around
  • strength exercises.

Hardware removal

Hardware used in surgery, like plates and screws, may need to be removed after two years.

Your child’s surgeon will give you more information about hardware removal and what to expect.

Disclaimer

This factsheet is provided for general information only. It does not constitute health advice and should not be used to diagnose or treat any health condition.

Please consult with your doctor or other health professional to make sure this information is right for you and/or your child.

The Sydney Children’s Hospitals Network does not accept responsibility for inaccuracies or omissions, the interpretation of the information, or for success or appropriateness of any treatment described in the factsheet.

© Sydney Children’s Hospitals Network 2024


This factsheet was produced with support from John Hunter Children's Hospital.