CURVED BONE

DEFORMITY CORRECTION

Deformity of the legs may result from congenital (congenital) bone diseases or may occur after growth cartilage damage in childhood or after improper union of the bone fracture. Some degrees of deformity have no clinical significance. However, over time, large degree of curvature causes pain in the ankle, knee and hip first and then arthrosis (calcification). If the nerves and vessels around the bone allow, the treatment of leg curvatures can be performed with a single operation. There is a risk of damage when large-grade curvatures will be corrected with an operation and the nerve and vascular structures will be stretched. In such cases, the deformity is gradually corrected (several degrees every day) with the help of external fixators placed outside the bone.

COMPUTER AIDED FIXATORS (TSF)

Fixators are one of the most reliable methods of treating deformity of the legs. The desired degree of deformity is gradually corrected after the surgery. Since fixators are suitable for post-operative weight bearing, they allow the patient to walk by stepping on their feet. Fixators are divided into two groups. Unilateral fixators are usually applied to the femoral bone. Circular fixators are also divided into two parts; ilizarov classical fixators and computer aided hexapod fixators. Ilizarov classic fixators require replacement in some cases after surgery, and the surgeon's experience is important. In computer-assisted hexapod fixators, the deformity value of the bone and the fixation parts used can be entered into the computer program and the leg deformity can be corrected with daily adjustments according to the correction template created. External fixators can also be used for bone lengthening.

INTRAMEDULLARY NAIL (EPF)

Femur and tibiade deformity can be completely corrected with intramedullary nails placed in the bone with meticulous preoperative measurement and planning.

PLATE AND SCREW (EPF)

In appropriate cases, it can be used for deformities around the knee. Plate corrections usually allow the patient to load the leg after 1.5 months. Plates and screws are used when high tibial osteotomy is performed to prevent arthrosis in the knee joint, especially after the age of 40.

WHAT IS A BOWED LEG?

The bowed leg is called genu varum in medicine. It is ideal that the mechanical axis of the leg passes through the middle of the knee joint as soon as a person is standing. Due to the curvature of the leg bones in the bowed, the mechanical axis of the leg passes through the inner part of the knee. When the person is viewed from the outside, the knee joint is protruding outward and there is a curvature in the form of a bow.

WHAT ARE THE REASONS FOR BOWED LEG?

In the leg, the calf bone (tibia) and thigh bone (femur) are connected by the knee joint. Curvatures that may exist in these two bones cause bowed. In many people, the exact cause is not known as it occurs developmentally. Fractures around the knee in childhood and wear in the knee joint in adult patients can also cause bowed.

Most of the patients who apply with the complaint of bowed legs have a curvature of the calf bone (tibia). When we examine more carefully, it will be seen that these patients have outward turning in the bone accompanying the curvature of the tibia. When the patient's feet look straight forward, the kneecaps turn inward. When the patient's knees are positioned to look straight forward, the leg bowed decrease, but the feet turn outward.

WHICH PATIENTS APPLY FOR BOWED LEG SURGERY?

Two groups of patients apply to us. The first group, people under the age of 45, want their legs to be seen straighter as an image. These people usually do not have pain in their knees or have occasional pain. The second group of patients applied to us with knee pain. The ages of these patients are generally around 50 years old and they started to have pain because of the wear on the knee joint due to the bowed leg.

BOWED LEG TREATMENT PROCESS

First, the patient's medical history is taken. It is questioned whether there is a previous fracture or metabolic bone disease. In the examination of the patient, it is checked whether the cause of the curvature of the leg is in the shin bone or thigh bone, and whether there is rotation (rotation) in the leg. The ligament structures of the knee joint are evaluated in terms of pain.

A leg radiography is requested from the patient as imaging. This graphy is very important for preoperative planning. All surgery planning will be done one-to-one on these graphs.

After examining the examination and radiological images, your doctor will tell you which bone should be corrected with which technique.

BOWED LEG TREATMENT METHODS

If the curvature is at low angles, a 5 cm incision is made below the knee in the measurements made on the graphies. After the tibia is cut properly, the angle of the bone is corrected according to the preoperative planning. The fixation of the bone is provided by a plate placed under the skin.

If there is a high degree of curvature or rotation (rotation) accompanying the curvature of the tibia, the correction is not performed immediately in the surgery. In such patients, it is necessary to use computer-assisted external fixators. In the surgery, after the bone is cut from the appropriate place, the fixator is placed on the outside of the leg. In the postoperative period, thanks to the data entered into the computer, the rotation and curvature of the leg are gradually corrected. Thus, nerve and vascular structures are preserved. The advantage of the external fixator is that it allows post-operative correction to the desired degree.

In some patients, the curvature originates from the thigh (femur) bone. In this case, the femur is cut from the appropriate place and fixed with a nail inserted into the bone.

BOWED LEG POSTOPERATIVE PROCESS

In surgeries performed only by placing a plate, the patient can walk with the help of a walker one day later, by giving weight to his leg as much as the pain allows. This process takes 45 days. If bone union is appropriate in the films taken after 45 days, the patient is allowed to walk without support. In this process, the patient is given an exercise program to strengthen the muscles around the knee.

Patients treated with a computer-assisted smart fixator can walk with the help of a walker 1 day after the operation. In these patients, correction is started after 5 or 7 days. Correction may take 7 days or more depending on the size of the curvature. After the correction is completed, the bone is expected to fuse. Since the external fixator carries a full load, there is no harm in walking by stepping on the patient. In these patients, complete union of the bone and removal of the fixator take 3-4 months. After boiling is complete, the fixator is removed.

BOWED LEG MEDICAL OR AESTHETIC?

Our female patients who applied with this complaint state that they want to wear skirts without hesitation with a straighter leg, while male patients want to have a straighter leg when they wear shorts or trousers.

Knee joint calcification (arthrosis) has many causes. One of them is the curvatures around the knee joint. For this reason, since the mechanical axis of the leg does not pass through the middle of the knee, it causes wear on the inner part of the knee. In patients with less wear on the knee, the curvature can be corrected and the patients' going to knee replacement surgery can be delayed.

ADVANTAGES OF BOWED LEG TREATMENT

A more uniform bone structure provides improvement in leg functions: Since the load distribution will be normal in a straight leg, the muscles and ligaments will work more smoothly. In this way, the possibility of damage to the muscles and ligaments will be reduced. The person will live a more functional life.

Correction of the bowed leg may prevent major surgical interventions in the future: Bowed leg patients may undergo knee replacement surgery in later ages. Although knee replacement surgeries will result in good results, it will not be like the person's own knee.

There is no method to correct bowed leg deformities without surgery. Since the problem is in the bone in this disease, the bone needs to be surgically corrected. No matter how much our patients want to have these surgeries from an aesthetic point of view, the mechanics of the knee joint will be corrected with the operation to be performed, so the wear on the knee joint in advanced ages will be prevented. Therefore, this surgery is performed for medical reasons as well as aesthetics.

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Bone Union
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The treatment process of malunioned or non-unionized fractures requires patience and meticulousness. We stand by our patients with our experience and techniques.

Foot
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In order to lead a healthy life by standing on your own feet, you can contact us if you have foot and ankle disorders.

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We are at your service in low back and spine treatments such as low back pain recovery exercises, scoliosis follow-up and surgery.

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Oscar Ville Ofisleri
No:26/1 Tekirdağ Merkez

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