Which Techniques Are Used in Osteotomy Surgery?

Which Techniques Are Used in Osteotomy Surgery?

Osteotomy surgeries are surgical interventions applied to correct bone structure. The various techniques used in these surgeries vary according to the patient's condition and desired outcomes. This article examines in detail the main techniques preferred in osteotomy surgery.

Osteotomy is an orthopedic surgical procedure performed by making controlled cuts in the bone to correct deformities, optimize load distribution, and improve joint function. This technique is frequently applied to weight-bearing joints such as the hip, knee, and ankle. The goal of osteotomy surgery is to reposition bone segments at specific angles and positions to reduce the patient’s pain, improve function, and prevent future collapse or osteoarthritis.

The osteotomy techniques vary depending on the surgeon’s preference, the type of deformity, and the area operated on. Fundamentally, the techniques used in surgery are shaped by the cutting method, the arrangement of bone segments, and the fixation method.

Bone cutting techniques are generally divided into three main groups: closing osteotomy, opening osteotomy, and translation osteotomy. The closing osteotomy method involves correcting the deformity by closing the gap created on the cut portion of the bone. Opening osteotomy mechanically creates a gap inside the bone to correct the deformity. In translation osteotomy, deformity is corrected by shifting the bone segments relative to each other.

The ways that bone gaps are created or closed also vary in terms of the shape of the cuts in the bone segments; these are generally classified as wedge, box, or straight cuts. In wedge cuts, the bone is cut from one side while the other side remains intact, allowing opening or closing correction. In box cuts, a specific segment around the bone is cut and repositioned. The shape of these cuts is planned according to the surgical goals.

Osteotomies can be performed using open or closed methods. In open osteotomy, the surgeon directly accesses the bone to make the cut. This method provides greater control and is preferred for wide-range corrections. Closed osteotomy is usually performed under minimally invasive principles, intervening in the bone with special cutting tools and guides without large skin incisions. This approach can shorten recovery time and reduce the risk of complications.

After the bone is cut, various fixation methods are used to stabilize the osteotomy. These include plate and screw systems, intramedullary nails, and external fixators. Plate and screw systems are the most commonly used fixation tools placed on the bone surface. Intramedullary nails are inserted inside the bone, providing more robust stabilization. External fixators are special devices attached to the bone from outside and can be adjusted as needed, especially preferred in cases with open wounds or high risk of infection.

Postoperative rehabilitation is critical to the success of the treatment. Physical therapy, muscle strengthening, increasing joint range of motion, and gradual weight-bearing protocols are planned. Additionally, periodic radiological examinations monitor the bone healing status and the durability of the correction after osteotomy.

The surgeon selects different techniques and combinations based on the patient's condition and deformity characteristics to achieve the best outcome. Therefore, each technique has its own advantages and limitations. The problem to be corrected must be clearly identified, the appropriate surgical technique selected, and the postoperative process followed carefully.