24105 Excision, olecranon bursa

Name of the Procedure:

Excision, Olecranon Bursa
Common name(s): Olecranon Bursa Removal, Removal of the Elbow Bursa

Summary:

The excision of the olecranon bursa is a surgical procedure to remove the bursa—a small fluid-filled sac located at the tip of the elbow—that has become inflamed, infected, or painful.

Purpose:

The procedure addresses olecranon bursitis, a condition where the bursa becomes swollen and painful due to inflammation, infection, or repetitive trauma. The goal is to relieve pain, reduce swelling, and restore normal function of the elbow.

Indications:

• Swelling, redness, and pain in the elbow area.
• Infection of the bursa (septic bursitis).
• Chronic bursitis that does not respond to conservative treatments (e.g., rest, ice, medications).
• Recurrent bursitis affecting daily activities and quality of life.
• A palpable lump on the elbow interfering with movement.

Preparation:

• Fasting for at least 6-8 hours before the procedure if general anesthesia is required.
• Stopping certain medications (e.g., blood thinners) as instructed by the healthcare provider.
• Blood tests and physical examination.
• Imaging tests, such as X-rays or MRI, to assess the condition of the bursa.

Procedure Description:

1. Anesthesia: Administered local anesthesia or general anesthesia, depending on patient needs.
2. Incision: A small incision is made over the olecranon bursa.
3. Removal: The inflamed or infected bursa is carefully removed.
4. Closure: The incision is closed with sutures or surgical staples.
5. Dressing: A sterile dressing is applied to protect the wound.

Surgical tools may include scalpel, scissors, forceps, and possibly surgical drains to prevent fluid accumulation.

Duration:

The procedure typically takes around 30 minutes to 1 hour, depending on the complexity of the case.

Setting:

Usually performed in a hospital or outpatient surgical center.

Personnel:

• Orthopedic surgeon or general surgeon.
• Surgical nurses.
• Anesthesiologist or nurse anesthetist (if general anesthesia is used).

Risks and Complications:

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Nerve damage or persistent numbness in the elbow or forearm.
• Scarring or impaired movement.
• Recurrence of bursitis.

Benefits:

• Relief from pain and swelling.
• Improved elbow mobility and function.
• Reduced risk of recurrent infection (in cases of septic bursitis).

Recovery:

• Apply ice packs to reduce swelling and alleviate pain.
• Keep the surgical site clean and dry.
• Follow prescribed medications for pain and infection prevention.
• Wear a sling or elbow brace as recommended.
• Sutures are typically removed within one to two weeks.
• Physical therapy may be advised to restore function.
• Full recovery usually takes 4 to 6 weeks, though activity restrictions may vary.

Alternatives:

• Conservative treatments: rest, ice application, anti-inflammatory medications, elbow padding.
• Aspiration: draining the bursa fluid using a needle.
• Corticosteroid injections to reduce inflammation.
• Each alternative has its own pros and cons, with surgery often being the choice when less invasive treatments fail.

Patient Experience:

During the procedure, if local anesthesia is used, the patient will be awake but should feel no pain. General anesthesia will render the patient unconscious. Post-procedure, pain is managed with prescribed medication, and patients may experience mild discomfort, swelling, and bruising. Follow-up appointments ensure proper healing and management of any complications.