Open Reduction, Salter Pelvic Osteotomy, and Femoral Shortening

It finally arrived.  The much-dreaded date of our daughter's "big surgery."  We worked hard to prepare Hip Chick as positively as possible this past week: numerous Hope the Hip Hippo readings, reviews of photos of her smiling in her first three casts, and her pre-op visit made preparing her for the experience much easier than preparing ourselves.  Mommy and Daddy's nerves provided a three to four hour catnap of sorts in place of sleep and, while I cannot speak for Daddy, mine were frought with nightmares.

Despite the early wake up, our little hippie held no shortage of spunk for her 5am admittance.  She was in a particularly chipper mood as she greeted staff members.  After donning her hospital gown, she was excited to walk the halls with Daddy- especially when she spied the carousel horse she loved so much from her first surgery.  When it was Mommy's turn to accompany her on a walk, she asked to sit and read.

When it came time, we cheerily told her that she was taking a special princess ride down the elevator.  She drank her dose of "goofy juice" and gave us high fives.  She and Mommy sung the "Choo Choo Soul" (Disney Jr) theme song as her nurse pushed her bed to the elevator.  We rode down to OR holding and met todays team, some of whom were familiar faces.  When asked her name, she proudly announced both her first and last names for all to hear. As the medicine took effect, her first name grew longer and longer, until she was announcing a first name of nearly a dozen syllables and plenty of giggles.  Neither frown nor tear crossed her face until they pulled her down the hall and around the corner for surgery.  Such a brave girl.

It was at this point that I cried like a baby.  Daddy gets the "strong backbone" award of the day.

And so began our routine.  While this was Hip Chick's second surgery, it was her fourth trip to the OR since this process began last February.  Cast changes are such an involved procedure that they require general anesthesia.  The buzzer above is becoming a rather familiar companion and, in a best case scenario, we will see it two or three more times after today.  We scooped up the buzzer and hopped downstairs for breakfast, then returned to her room to read and wait out the surgery.

We received a buzz roughly a half hour after she went to the OR.  They confirmed that all began well and we would receive an update in two hours.  Our second update indicated the first half of her procedures were complete, she was doing well, and had incurred minimal blood loss.  Five hours after she was taken into the OR, we receives the update we were waiting for:  she did great!  Everything occurred according to plan.  

So what did her surgery entail?  They performed a femoral shortening, meaning they cut her femur completely through and removed a centimeter of length.  Her femur is now held together with a plate.  They performed an open reduction, meaning they placed the femur into socket with the hip surgically opened.  They performed a pelvic osteotomy,  specifically a salter (there are various types of pelvic osteotomies).  For this, they cut through the pelvic bone on the left side and rotated it down to help round out her malformed socket.  This is also held together with hardware.  Lastly, she is back in a spica cast... and a different form than anticipated. 

Her recovery room nurse (who has previously cared for her in day surgery recovery) remarked on how well she did waking from anesthesia.  Our little hippie was able to converse far better than expected for her age.  She never ceases to impress.

And now to begin the recovery process.  When I explained to her on Saturday that she would have a new cast, I took a tip from her book and advised that her legs and hips needed to rest, so they can grow strong.  Strong she is and strong she will be.