Tibial Osteotomy (Supramalleolar Osteotomy or SMO)
Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.
Definition:
Osteotomy means to cut the bone. The Tibia is one of the bones that makes up the shin. Therefore, a tibial osteotomy is the cutting of the shin bone. The usual reason why a tibial osteotomy is recommended is to correct a "twist" in the tibia (tibial torsion). Untwisting the bone is usually performed near the ankle. (see diagram) The bold dotted line represents where the bone is cut.
After the bone is cut, screws and plates may be used to fix the bones in position and ensure that it heals in the correct position. These are usually removed up to two years after surgery. Sometimes, wires are required to fix the bones and these are usually removed in clinic around 4-6 weeks following surgery. Your surgeon will inform you of the exact plan.
Weight Bearing:
4-6 weeks of non-weight bearing is usually prescribed to allow the bone to heal.
Plasters:
Short leg casts from below the knee down to the toes.
Orthoses:
Ankle foot orthoses (AFOs) are often needed after the casts are removed. AFOs commonly need to be worn all the time for the first 3 months, after which your surgeon will inform you of how often you will need to wear them.
Special Instructions:
Do not let leg turn inwards or outwards for long periods of time. The knee caps and feet should point in the same direction at all times.
Equipment:
Your child will need a wheelchair and perhaps a hoist and a commode to help with toileting. Speak to your Occupational Therapist for further recommendations and assistance.
© The Children's Hospital at Westmead - 1997-2010
This document was published on Thursday, 11 February 2010.
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