SUFE Corrective Osteotomy

⚙️What This Procedure Involves

Several osteotomy techniques are available depending on the severity and location of the deformity. The Imhäuser osteotomy (intertrochanteric flexion, valgus, and internal rotation osteotomy) is the most commonly used. The femur is cut, realigned to compensate for the slip, and fixed with a plate and screws. For severe slips, a modified Dunn procedure (subcapital realignment through a surgical hip dislocation approach) may be considered at specialist centres. The operation takes two to three hours.

💡Why It May Be Recommended

Corrective osteotomy is recommended for chronic SUFE with significant residual deformity causing femoroacetabular impingement, restricted hip movement (particularly internal rotation and flexion), and pain.

⚖️Non-Operative Alternatives

Physiotherapy and activity modification for mild deformity. Arthroscopic osteochondroplasty may address mild cam impingement from healed SUFE. Severe deformity requires osteotomy.

📋Preparing for Surgery

CT scan with 3D reconstruction for planning. Assessment of hip range of motion. This is a specialist procedure.

✅Expected Benefits

Improved hip range of motion, reduced impingement, and relief of pain. Prevention of early-onset hip arthritis.

⚠️Common Risks

• Leg length discrepancyCommon

  May result from the osteotomy.

• Altered gaitCommon

  Temporary changes in walking pattern.

• Hardware prominenceCommon

  Plate and screws may be palpable.

🔴Less Common but Serious Risks

• AVNUncommon

  Risk to the femoral head blood supply, particularly with more aggressive realignment techniques. Risk varies from 5% (intertrochanteric) to 10-15% (subcapital).

• ChondrolysisUncommon

  Cartilage destruction. Risk approximately 5%.

• Non-unionRare

  The osteotomy may fail to heal.

• Over-correction or under-correctionUncommon

  Imperfect realignment.

• InfectionUncommon

  Wound or deep infection.

💉Anaesthetic Considerations

General anaesthesia. Positioned supine or lateral.

🏃Recovery and Rehabilitation

Non-weight-bearing or partial weight-bearing for six to eight weeks. Crutches. Physiotherapy for hip range of motion. Full recovery three to six months. Metalwork removal may be planned at twelve months.

📅Follow-Up

Regular X-rays at six weeks, three months, and six months. Long-term monitoring of the hip joint.

❓Frequently Asked Questions