When osteotomy is the only solution for your patient, you must pay attention to a couple of factors.
The world is in constant progress. When it comes to orthopedics, there is always someone who wants to help you to improve your work and tries to find the best solution thinking about your patient, as well.
The piezoelectric device is useful on small osteotomies. Using a fine tip it allows curved cutting and provides a new opportunity for new osteotomy techniques. This device has great potential to be used in spinal and hand surgeries.
In order to test this device and since it was ideally designed for hand surgery, it was used on a 23 years old’s hand osteotomy who suffered from a malunited metacarpal bone fracture on his fifth finger from his dominant hand. The cutting was very precise. The edges of the osteotomy were all sharp and there was no need to split the bone or neither danger of a break out.
The device can be moved in all directions and it can be compared to a pen. The tip of the instrument is exchangeable. Using the fine tip allows you to do a curved cutting and because of the automatic water-cooling during the whole procedure, there is always a clear view into the object.
Osteoarthritis can be one of the main causes to be developed when the bones of the knee and leg do not align properly putting additional stress onto the joint surface, causing wear and tear.
Remember that osteotomy is usually indicated for younger and more active patients whose arthritis is at an early stage, so be alert and keep following the news in the field and before improving the patient’s life, improve yours.
The Clamshell Osteotomy
The treatment procedure for a complex diaphyseal malunions can be viewed as a challenge for you. It requires an extensive pre-operative planning and precise operative technique but there is a new method called clamshell osteotomy, that may simplify those deformities.
The number one indication to submit a patient to this kind of surgery is the pain at adjacent joints followed by deformity.
In practice, this new technique resulted in a correction ranging from 2 to 20 degrees in the coronal plane, 0 to 32 degrees in the sagittal plane and 0 to 25 degrees in the axial plane. The limb length was restored to within 2 cm in all the patients, tested for 6 months and no deep infections occurred.
The clamshell osteotomy procedures aim to be an useful way to correct many forms of complex diaphyseal malunion. This new technique can also decrease pre-operative planning time and complexity as well.
Vertebral Body Stapling and Wedge Osteotomies
At the Philadelphia Hospital, there is a group of investigators trying to figure out how to correct the spine deformity by not having to fuse the spine to correct the curvature movement, in order to maintain the flexibility, allowing to preserve the motion and decrease the chance for back pain in scoliosis patients.
Twenty years ago, surgeons tried to use staples in the spine for stabilization of scoliosis but failed because the staples would dislodge and fall into the chest. As the years passed, improvements in the technology field led to develop a staple made of a memory-shaped alloy. This staple when placed in an ice bath, can be bent straight for insertion. After inserting it into the spine, upon heating to body temperature the staple returns to its original clamp shape, which prevents it from dislodging.
This technological advance has allowed physicians to reconsider its use for correction of spine deformity. At Philadelphia Hospital, these staples were used in 9 young patients with idiopathic scoliosis. The follow up of this procedure conclude that all the curves were maintained and none has progressed. The patients needed to be braced for one month after the surgery, but once the brace was removed there was no restrictions on the daily activities. In the 9 patients who were submitted to this procedure, the deformity seemed to be corrected and it did not get worse which suggests that we may have finally get a situation where the vertebral body osteotomies can be performed safely.
In the osteotomy field, some new techniques have been improving the work of “cutting off the bone” and we can only hope that these new procedures will soon become effective treatment options for your patient.