osteotomische

Osteotomy is a surgical procedure that involves cutting and realigning bone to correct deformities, redistribute load, or restore function after injury. The term combines Greek roots for bone (osteo) and cutting (tomy). Osteotomies may be performed on long bones, the pelvis, the jaw, or the spine, and are usually followed by stabilization with implants or external devices.

Indications include angular deformities of the limbs, malunited fractures, limb-length discrepancy, and joint-preserving correction in osteoarthritis. In maxillofacial surgery, orthognathic osteotomies reposition the jaws to improve occlusion and facial aesthetics. Spinal osteotomies, such as pedicle subtraction osteotomy, correct sagittal imbalance in severe kyphosis or scoliosis. The specific procedure depends on the deformity, bone quality, and desired amount of correction.

Techniques vary: closing wedge osteotomy removes a wedge of bone to reduce an angular deformity, while opening wedge osteotomy creates a gap that is often filled with bone graft to achieve correction without shortening the limb. Dome and oblique osteotomies provide alternative planes of correction. Stabilization is commonly achieved with internal fixation using plates and screws or intramedullary devices, though external fixators may be used in certain cases. Healing and rehabilitation are influenced by the chosen technique and fixation method, as well as patient factors.

Risks include infection, nonunion or delayed union, neurovascular injury, injury to surrounding tissues, implant-related complications, and the possibility of under- or over-correction. When appropriately planned and executed, osteotomies can restore alignment, balance mechanical loads, relieve symptoms, and preserve or restore function.