25130 Excision or curettage of bone cyst or benign tumor of carpal bones

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Carpal Bones

Summary

This procedure involves removing a non-cancerous tumor or cyst from the small bones in the wrist area. The surgeon either cuts out (excises) or scrapes away (curettes) the abnormal growth to relieve symptoms and prevent complications.

Purpose

This surgery is performed to address benign bone tumors or cysts in the carpal bones, which are small bones in the wrist. The goals are to alleviate pain, prevent the cyst or tumor from causing structural damage, and restore normal function to the hand and wrist.

Indications

• Persistent pain in the wrist not relieved by other treatments.
• Swelling or a noticeable mass in the wrist area.
• Decreased range of motion or functional impairment of the wrist.
• Risk of fracture or other complications due to the cyst or tumor.
• Diagnosis of a benign tumor or cyst confirmed through imaging tests.

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments, such as stopping blood thinners or anti-inflammatory drugs, may be necessary.
• Pre-operative imaging, such as X-rays or MRI, to assess the size and location of the cyst or tumor.
• Blood tests and other pre-surgical assessments as needed.

Procedure Description

1. Anesthesia: The patient receives general anesthesia to ensure they are asleep and pain-free during the surgery.
2. Incision: A small incision is made over the affected area of the wrist.
3. Excision/Curettage: The surgeon carefully removes the cyst or tumor by either excising it entirely or curetting (scraping) the contents and lining of the cyst or tumor.
4. Closure: The incision is closed with sutures, and the area is bandaged.
   • Tools used may include scalpels, curettes, and imaging equipment for precise localization of the cyst or tumor.

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and size of the cyst or tumor.

Setting

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

Personnel

• Orthopedic surgeon or hand surgeon
• Anesthesiologist
• Surgical nurses and/or assistants

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma formation
• Damage to surrounding tissues or nerves
• Recurrence of the cyst or tumor
• Adverse reactions to anesthesia

Benefits

• Pain relief and improved wrist function.
• Prevention of future complications such as fractures or joint damage.
• Most patients start to notice improvement within a few weeks following surgery.

Recovery

• Postoperative care includes keeping the wrist immobilized in a splint or cast for a specified period.
• Pain management with prescribed medications.
• Instructions on wound care and activity restrictions.
• Physical therapy may be recommended to restore wrist movement and strength.
• Follow-up appointments to monitor healing and recovery.

Alternatives

• Non-surgical management such as aspiration and steroid injection (may provide temporary relief but not a permanent solution).
• Observation and regular monitoring for small, asymptomatic cysts or tumors.
• Pros include avoiding surgery, cons include potential recurrence or worsening of symptoms.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel anything. After the procedure, there may be some pain, swelling, and discomfort in the wrist, which can be managed with pain relievers and rest. Patients can expect a period of restricted wrist movement and will gradually return to normal activities as healing progresses.