Osteotomy — Distal Femoral Rotational Osteotomy

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

NWB x 3 weeks (long leg cast with derotation spreader bar or abduction pillow); partial WB weeks 3-6 per MD in cylinder/long leg cast; full WB at 6 weeks per MD; healing 6-8 weeks

Key Restrictions

No impact, torque, or unprotected WB x 3 weeks; minimize fall risk; do not lift child by spreader bar; spasticity complications on cast removal; avoid aggressive ROM initially

Timeline & Phases

Phase 1 (days 1-7): NWB, pain management, safe transfers/ADLs, hip/ankle PROM/AAROM/AROM, isometrics, balance for transfers; Phase 2 (days 8-21): pain management; Phase 3 (day 22+): avoid impact/torque, progressive WB per MD, bracing/assistive devices, scar mobility ~6 weeks, full LE ROM all planes, LE strengthening (glutes/calves), quality gait, return to pre-op function

Notes

Pediatric; indication is femoral anteversion or retroversion; femur rotated at distal femoral metaphysis with internal hardware (plates or wires); Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007