23180 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle

Name of the Procedure:

Partial excision (craterization, saucerization, or diaphysectomy) of the bone, specifically the clavicle.

Summary

Partial excision of the clavicle involves surgically removing a diseased portion of the clavicle bone. This procedure can be done using methods such as craterization, saucerization, or diaphysectomy to treat bone infections or other conditions affecting this bone.

Purpose

Partial excision of the clavicle is typically performed to treat osteomyelitis, a severe bone infection. The primary goals are to eradicate infection, relieve pain, and restore function to the affected area.

Indications

• Chronic osteomyelitis or severe bone infection unresponsive to antibiotics.
• Persistent pain and swelling in the clavicle.
• Failure of previous treatments.
• Abscess formation or other signs of severe infection.
• Bone damage or necrosis.

Preparation

• Fasting for at least 8 hours prior to the procedure.
• Adjustments to current medications as advised by the physician.
• Preoperative blood tests, imaging (X-rays, MRI, or CT scans), and other diagnostic assessments.
• Informing the healthcare team about any allergies or existing medical conditions.

Procedure Description

1. The patient is positioned to provide access to the clavicle.
2. General anesthesia is administered to ensure the patient is unconscious and pain-free.
3. An incision is made over the infected area of the clavicle.
4. The surgeon removes the diseased or damaged bone using techniques like craterization, saucerization, or diaphysectomy.
5. The area is thoroughly cleaned to remove any infectious material.
6. The wound is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes about 1 to 2 hours, depending on the extent of the infection and the complexity of the surgery.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Orthopedic or general surgeon.
• Anesthesiologist.
• Surgical nurses and assistants.
• Radiologic technologist (if intraoperative imaging is needed).

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Damage to surrounding tissues or nerves.
• Incomplete removal of infected bone.
• Delayed healing or non-union of the bone.
• Risks associated with general anesthesia.

Benefits

• Removal of the source of infection.
• Pain relief.
• Improved function and mobility.
• Prevention of the spread of infection to other parts of the body.

Recovery

• Hospital stay for a few days post-surgery for observation and pain management.
• Antibiotic therapy may be continued.
• Instructions on wound care and keeping the area clean and dry.
• Avoiding strenuous activities and heavy lifting for several weeks.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Long-term antibiotic therapy alone, though less effective for chronic cases.
• Hyperbaric oxygen therapy to enhance antibiotic efficacy and bone healing.
• Orthopedic debridement combined with other surgical techniques.

Patient Experience

• The patient will be under general anesthesia during the procedure and will not feel any pain.
• Post-operative pain and discomfort managed with prescribed pain medications.
• Swelling and bruising around the surgical site can be expected.
• Regular follow-ups to ensure successful recovery and monitor for any complications.