I'd like to hear from those of you who have had the femoral de-rotational osteotomy...what are your thoughts about having it at a young age vs. waiting til the adult years? Also, how has this surgery helped you, and are there any drawbacks to having had it?
***For those who haven't read my heel cord post, my son Noah is 7 years old and has spastic diplegia CP. He had SDR surgery four years ago and is highly functional. Our Dr. here was considering a foot osteotomy, but has decided to hold off on surgery until he can't function well anymore. We got a second opinion from Dr. Campion at UNC (to see if he had any ideas about braces, since Noah's feet won't tolerate them any more).
Dr. Campion said he recommended Noah getting a femoral de-rotational osteotomy and lengthen his heel cord at the same time as soon as possible. He thought doing it early would help prevent further bone deformities. ***
We're trying to weigh these two vastly different options, and decide what to do.
Thanks for your help!
nwmom
Re: need feedback re. femoral de-rotational osteotomy
Our ortho we spoke to today about the exact same thing said that research that is coming out now suggests that doing it in the younger years is not neccesarily a bad thing and, at least in my sons case, unlikely to have to have it repeated. My 6 1/2yo son has Spastic diplegia too. Our son was a candidate for SDR but the hosp we are attached to is no longer doing them.
Re: need feedback re. femoral de-rotational osteotomy
Well, I'm now trying to find information on how SDR patients fare with heel cord lengthening surgery. From the research I've been able to find, there seems to be some cautions put out there by some doctors who say that spastic diplegics often develop a crouch gait after TAL. But I don't know which ones of these have had SDR...nor do I know if they were ambulatory kids. I'm not a great researcher and I'm having trouble finding out how SDR patients do with the heel cord lengthening. Any advice is most welcome!
We have scheduled a follow-up appt. with Dr. Campion in Chapel Hill in late Sept. He seems to be the surgeon with the most experience with FDO's and TAL's in our network.
I'll let you know what we decide--thanks for asking!
Re: need feedback re. femoral de-rotational osteotomy
Can I ask what femoral de-rotation osteotomy does?
I am wondering, our child is due to have SDR in October. I have noticed more recently that one of her legs turns in at the knee a lot more when she walks and therefor the foot turns and drags on the ground. She uses a k-walker and this happens when she is wearing her AFOs - is this the sort of surgery they do to correct it?
I am in Ireland and we are travelling to Missouri for the surgery (SDR) in October. Over here in Ireland there is little surgical intervention for children with CP and we are left in the dark a lot of the time and are just expected to rely on infrequent physio services
Re: need feedback re. femoral de-rotational osteotomy
Well, I'm no expert, but here's what I've been finding out about that for Noah. In general, the FDO surgery helps your feet to point out straight instead of turning in. Dr. Campion seems to think Noah needs this, but the head PT where we go suggested that we botox his medial hamstring first to see if that may be more of the cause of his foot turning in. She said it was hard to tell exactly what the cause was. Everyone we talk to has a different opinion on what's best. I think you'll like the Children's Hospital in St. Louis. They have a great set-up for the kids and for their families.
