Orthopedic surgeons at Hassenfeld Children’s Hospital at NYU Langone are experienced in performing surgical procedures to correct severe lower-leg curvature. Surgery is generally recommended for children older than age three, teens, or younger children with severe bowing that cannot be corrected with leg braces. Children in these groups may already have extensive bone damage due to Blount disease that cannot be corrected with nonsurgical treatment.
Growth plate surgery, also called hemiepiphysiodesis, temporarily stops the normal-length portion of the leg bone from growing, so that the shorter side can catch up. This surgical procedure is often used in children who are still growing, because there is time for the discrepancy in leg length to be corrected.
In this procedure, the surgeon makes a small incision at the growth plate and attaches a titanium plate to the side of the bone with titanium screws. Growth plate surgery is an outpatient procedure that can be completed in about one hour. Your child may need to use crutches for a few weeks after surgery to allow the bones to heal.
To straighten your child’s lower legs, our surgeons may perform an osteotomy to reset the misshapen bone. They do so by realigning it with internal pins, plates, and screws, or with an external fixator—a frame worn outside the body and attached to the shinbone with pins—that is attached during osteotomy surgery. Wearing the fixator corrects bone alignment and reverses outward rotation of the leg bone. Additional rods may be used to stabilize the frame, which your child may wear for 8 to 12 weeks.
An external fixator may also be used to correct a difference in leg length that cannot be corrected by surgery alone. The fixator stabilizes the shorter leg while gradually correcting the shape of the bone, a process called distraction osteogenesis. Because the device provides stability, children are still able to walk while wearing an external fixator.
Rarely, if the inner portion of the shinbone has been permanently damaged and is sloped, the surgeon may reshape it with a graft, which is a small, wedge-shaped piece of bone taken from the child’s pelvis or obtained from a donor.
Osteotomy is performed while your child is under general anesthesia. Most children stay in the hospital for two to three days after this surgery.
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