24140 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus

Name of the Procedure:

Partial Excision (Craterization, Saucerization, or Diaphysectomy) of Bone (e.g., Osteomyelitis), Humerus

Summary

In simple terms, this procedure involves surgically removing a portion of the humerus bone to treat bone infections like osteomyelitis. The surgeon may use techniques such as craterization or saucerization to eradicate the infected area.

Purpose

The procedure specifically addresses osteomyelitis, an infection of the bone. The primary goal is to remove the infected or dead bone tissue to prevent the infection from spreading and to promote healing.

Indications

• Persistent or severe bone infection (osteomyelitis) in the humerus.
• Failure of antibiotic therapy to resolve the infection.
• Presence of necrotic (dead) bone tissue.
• Chronic pain or impaired function of the arm due to infection.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Adjustments to any medications, especially blood thinners, will be advised.
• Preoperative imaging studies like X-rays or MRI scans, and blood tests will be conducted for comprehensive assessment.

Procedure Description

1. The patient receives anesthesia (general or regional, depending on the case).
2. An incision is made over the infected area of the humerus.
3. The surgeon uses specialized tools to remove the infected or necrotic bone tissue (craterization or saucerization).
4. The area is thoroughly cleaned, and if necessary, bone grafts or implants may be used to support the remaining bone structure.
5. The incision is closed, and a sterile dressing is applied.

Duration

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

Setting

This procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Scrub technician

Risks and Complications

• Infection at the surgical site
• Blood loss
• Injury to surrounding tissues or structures
• Incomplete removal of the infected bone, requiring additional surgery
• Adverse reactions to anesthesia
• Delayed recovery or prolonged pain

Benefits

• Effective removal of infection, leading to pain relief
• Prevention of infection spread
• Improved function and mobility of the arm
• Enhanced overall quality of life

Recovery

• The patient might need to stay in the hospital for a few days.
• Postoperative care includes medications for pain and antibiotics to prevent further infection.
• Physical therapy may be prescribed to restore movement and strength.
• Full recovery may take several weeks to months, with activity restrictions and follow-up appointments for monitoring.

Alternatives

• Long-term antibiotic therapy alone.
• Amputation in severe, unmanageable cases.
• Less invasive debridement procedures if the infection is localized and not extensive.

Pros and cons of alternatives:

• Antibiotic therapy alone may not be sufficient in severe cases.
• Amputation is a last resort with significant lifestyle impacts.
• Less invasive debridement may not completely eradicate the infection.

Patient Experience

During the procedure, the patient will be under anesthesia and thus feel no pain. Postoperatively, discomfort and pain at the incision site are common, managed with pain medications. Temporary immobilization of the arm may be required. The surgical team will provide measures to ensure the patient’s comfort and facilitate a smooth recovery.