An osteotomy is a surgical procedure that involves the precise cutting and reshaping of bone. A foot osteotomy corrects deformities or enhances foot function, addressing structural issues that cause pain and mobility limitations.
What is a Foot Osteotomy?
The term “osteotomy” originates from Greek words, where “osteo” refers to bone and “tomy” means cutting. In the foot, this procedure involves surgically cutting a bone to realign, shorten, lengthen, or alter its angle. Its purpose is to redistribute pressure, correct deformities, stabilize joints, and alleviate pain.
Different types of bone cuts include removing a wedge (wedge osteotomy), creating an opening to lengthen (opening wedge osteotomy), or creating a closing to shorten (closing wedge osteotomy). The specific cut depends on the individual’s condition and desired correction. This modification helps restore the foot’s natural anatomy and improve its mechanical function.
Why Foot Osteotomy is Performed
Foot osteotomy addresses conditions causing pain, instability, or difficulty walking due to bone misalignment or deformity. Common reasons include bunions, hammertoes, flatfoot deformities, and high arches. The procedure is considered when non-surgical treatments, like orthotics or physical therapy, have not provided adequate relief.
For bunions, an osteotomy realigns the metatarsal bone at the base of the big toe, correcting its angle and reducing the painful bump. For hammertoes, the procedure may involve shortening or repositioning metatarsal bones to straighten the affected toe. Flatfoot can be addressed with a calcaneal osteotomy, which repositions the heel bone to restore the arch, or a cotton osteotomy for arch creation. A Dwyer osteotomy can reshape the foot to reduce a high arch.
The Surgical Procedure
A foot osteotomy begins with anesthesia, which can be general, regional, or local, depending on the surgery’s extent and patient preference. The surgeon makes an incision over the specific area requiring correction.
The bone is then cut, and a small wedge may be removed or added. After repositioning, it is secured using internal fixation devices like screws, plates, or pins. These devices hold the bone firmly in its new position while healing occurs. The incision is closed with stitches, and a protective bandage is applied.
Recovering from Foot Osteotomy
Recovery involves a structured approach for proper healing and function restoration. Immediately after surgery, the foot is bandaged, and pain is managed with prescribed painkillers. Swelling is common and may persist for three to six months, making elevation and rest important.
Weight-bearing is restricted for six to eight weeks, requiring crutches or a special walking boot to protect the healing bone. A cast may be applied after initial swelling subsides. Physical therapy begins within a few weeks to gradually restore strength, flexibility, and mobility. Full recovery ranges from three to six months, though complex cases might require up to a year.
Expected Results and Considerations
A successful foot osteotomy leads to pain reduction, improved foot function, and correction of the underlying deformity. Patients experience better balance and comfort when wearing shoes, enhancing mobility and daily activities. The procedure can also reduce the long-term risk of conditions like arthritis from continued misalignment.
Potential considerations include infection risk at the incision site or within the bone, and nerve damage causing numbness or tingling. Other possibilities include delayed bone healing, non-union (failure of bone to fuse), or persistent stiffness. Though rare, revision surgery might be needed if the deformity recurs or complications arise.