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Bone malrotation refers to the situation that results when a bone heals out of rotational alignment from another bone, or part of bone. It often occurs as the result of a surgical complication after a fracture where intramedullary nailing (IMN) occurs, [1] especially in the femur and tibial bones, but can also occur genetically at birth.
X-ray of Femoral Osteotomy hardware to correct femoral rotation caused by hip dysplasia. X-ray of the right hip in female patient in early thirties. Two main types of osteotomies are used in the correction of hip dysplasias and deformities to improve alignment/interaction of acetabulum – (socket) – and femoral head – (ball), innominate osteotomies and femoral osteotomies.
Rotationplasty is also performed on children with congenital femoral deficiencies. Those deficiencies cause "unstable hip joint[s] and a femur that is 50% shorter than the contralateral, normal femur." [6] This procedure gives rotationplasty patients the ability to have the use of both feet and allows them to continue living an active lifestyle.
Most of the time surgery is eventually required and may include core decompression, osteotomy, bone grafts, or joint replacement. [1] About 15,000 cases occur per year in the United States. [4] People 30 to 50 years old are most commonly affected. [3] Males are more commonly affected than females. [4]
Over time, there is a decreasing trend of percentage patency (likelihood a vessel will remain open) in popliteal bypass surgery, 88% in the first year, 79% and 76% at 3 and 5 years respectively. [13] Environmental conditions and overall patient health may also affect the patency of the graft.
High tibial osteotomy is an orthopaedic surgical procedure which aims to correct a varus deformation with compartmental osteoarthritis.Since the inception of the procedure, advancements to technique, fixation devices, and a better understanding of patient selection has allowed HTO to become more popular in younger, more active patients hoping to combat arthritis. [1]
The neck of the femur is usually removed at the same time as the head. This prevents the post operative complication of bone rubbing on bone and continued pain. This has led to the procedure often also called "Femoral head and neck ostectomy". [citation needed]
The primary aim of surgery is to correct the fit of the femoral head and acetabulum to create a hip socket that reduces contact between the two, allowing a greater range of movement. [30] This includes femoral head sculpting and/or trimming of the acetabular rim. [30] [31] Surgery may be arthroscopic or open. [7]