24110 Excision or curettage of bone cyst or benign tumor, humerus

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor, Humerus

Summary

This surgical procedure involves removing a bone cyst or benign tumor from the humerus (upper arm bone). It can be performed using excision (cutting out the lesion) or curettage (scraping out the lesion).

Purpose

• Medical Condition: Treatment of bone cysts or benign tumors in the humerus.
• Goals: Remove the abnormal growth to prevent further complications such as bone weakening or fractures, and relieve any associated pain or discomfort.

Indications

• Pain in the upper arm.
• Swelling or noticeable lump on the humerus.
• Bone weakening or risk of fracture detected on imaging studies.
• No response or recurrence after non-surgical treatments.

Preparation

• Pre-procedure Instructions: Fasting for at least 6 hours before the procedure if general anesthesia will be used.
• Medications: Adjustments or temporary discontinuation of certain medications as advised by the physician.
• Diagnostic Tests: X-rays, MRI, or CT scans to accurately locate the cyst or tumor and assess the extent of the lesion.

Procedure Description

1. Anesthesia: General or local anesthesia is administered; anesthesia type depends on the case specifics.
2. Incision: A small incision is made over the site of the cyst or tumor.
3. Excision or Curettage:
   • Excision: The cyst or tumor is carefully cut out.
   • Curettage: The lesion is scraped out using a special tool called a curette.
4. Filling the Space: Sometimes the cavity left is filled with a bone graft or synthetic material to support bone healing.
5. Closure: The incision is closed with sutures or staples.
6. Dressing and Bandage: The area is dressed and bandaged.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

The procedure is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Medical assistants

Risks and Complications

• Common Risks: Infection, bleeding, and swelling.
• Rare Risks: Damage to surrounding tissues, nerve injury, and recurrence of the cyst or tumor.
• Management: Antibiotics for infections, pain management medications, and follow-up assessments.

Benefits

• Removal of the cyst or benign tumor.
• Alleviation of pain and discomfort.
• Prevention of potential fractures or further complications.
• Improved arm function and strength.

Recovery

• Post-Procedure Care: Keeping the arm elevated, applying ice packs, and taking prescribed pain medication.
• Restrictions: Limited arm movement and avoiding heavy lifting for several weeks.
• Follow-Up: Regular check-ups to monitor healing and ensure there is no recurrence.

Alternatives

• Non-surgical Options: Observation, casting, or medication.
• Pros and Cons of Alternatives:
  • Observation and medication may be less invasive but can lead to prolonged symptoms if the cyst or tumor grows.
  • Surgical removal directly addresses the issue but comes with surgical risks.

Patient Experience

• During the Procedure: The patient will be under anesthesia and will not feel pain.
• After the Procedure: Some pain and swelling are expected, which can be managed with medications. Discomfort typically lessens within a few days to weeks.
• Pain Management: Prescribed pain relief and comfort measures such as ice application and arm support.

Patients can expect to gradually return to normal activities within a few weeks, with full recovery potentially taking a couple of months.