Lower limb deformity correction is often carried out at the same time as limb lengthening surgery to achieve the best possible outcome. Deformities of the lower limbs (legs and feet) can develop before a child is born or during early childhood, or as a result of an injury. They may vary in severity from deformities that affect someone’s mobility to those that are purely aesthetic.
Lower leg deformities are corrected using a procedure called osteotomy. This entails making a cut to the bone and then realigning bones and joints so they are correctly positioned. They are then stabilised, in some cases using an external fixator, as in limb lengthening surgery. A fixator is a frame that attaches to the end of the bone, keeping it in the correct position and allowing new bone to grow to fill any gaps. Osteotomies are an effective method of joint preservation. By realigning the joints so they are working correctly the procedure helps to prevent any further joint damage.
You might be offered this type of surgery if you have had lower limb deformity since birth or early childhood, or if you have developed the condition as a result of an accident or injury. Deformities in children are often caused by genetic abnormalities, the position of the foetus in the womb or nutritional deficiencies.
Among the conditions that might be suitable for this type of surgery are:
- Club foot (congenital talipes equinovarus) which is a congenital abnormality that causes a child’s foot to twist inwards at the ankle.
- Flat foot or fallen arches (pes planus) which is a condition where the natural arch of the foot fails to develop or collapses.
- High arch which is a condition that causes the foot arch to become abnormally pronounced, causing pain in the ball and heel of the foot.
- Tarsal coalition which is where two or more tarsal bones fuse.
- Bowed legs (congenital genu varus) which causes an abnormal outward curve in one or both legs.
Recovery times vary depending on the procedure that is carried out, the extent of surgery required, your age and general health and wellbeing. Before surgery you will be screened to check for levels of Vitamin D and to rule out infection or other potential problems that may affect the outcome of surgery. After surgery you can help to speed up your recovery by keeping weight off the affected limb and raising your leg above the level of your heart as much as possible during the first few days. It is important that you follow the surgeon’s advice about keeping the wound clean and dry and that you do any exercises set by the physiotherapist as these will help you to regain a full range of movement and flexibility. You should not smoke or take anti-inflammatories as these can impede healing.
This type of surgery has a good success rate, particularly when carried out alongside limb lengthening.