Osteotomy, radius; middle or proximal third
CPT4 code
Name of the Procedure:
Osteotomy, radius; middle or proximal third
Summary
An osteotomy of the radius is a surgical procedure where a surgeon cuts and repositions a section of the radius bone in the forearm. This procedure specifically targets the middle or proximal (nearer to the body) third of the radius.
Purpose
An osteotomy of the radius is performed to correct deformities, relieve pain, and restore function when conservative treatments have failed. It is commonly done to address issues such as improperly healed fractures, congenital deformities, and certain types of bone and joint diseases.
Indications
- Malunion or nonunion of radius fractures
- Congenital deformities of the radius
- Radius bone misalignment affecting wrist or elbow function
- Chronic pain related to malalignment
Osteoarthritis or other degenerative joint diseases
Preparation
- Pre-surgery fasting, typically from midnight before the surgery.
- Adjustments to regular medications as advised by the surgeon.
- Diagnostic imaging studies such as X-rays or CT scans to plan the surgery.
- Blood tests and a medical evaluation to ensure the patient is fit for surgery.
Procedure Description
- Anesthesia: General or regional anesthesia is administered.
- Incision: A surgical incision is made at the designated site on the forearm.
- Bone Cutting: The surgeon carefully cuts the radius bone at the middle or proximal third.
- Realignment: The bone is repositioned to the desired alignment.
- Fixation: The bone is stabilized using plates, screws, or pins to maintain correct alignment during healing.
- Wound Closure: The incision is closed with sutures or staples and bandaged.
Duration
The procedure typically lasts between 1 to 3 hours, depending on the complexity of the surgery.
Setting
The procedure is usually performed in a hospital or a specialized surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection at the surgical site
- Blood clots
- Nerve or blood vessel damage
- Nonunion or delayed union of the bone
- Hardware complications (e.g., plates/screws malfunction)
- Need for additional surgery
Benefits
- Corrected bone alignment
- Improved function and range of motion
- Alleviation of pain
- Enhanced ability to perform daily activities
Recovery
- Post-surgery hospital stay for monitoring (if necessary).
- Pain management with prescribed medications.
- Immobilization with a cast or splint to protect the area.
- Instructions for gentle range-of-motion exercises as healing progresses.
- Follow-up appointments to monitor healing, usually involving X-rays.
- Physical therapy may be needed to restore strength and mobility.
- Full recovery can take several months, depending on individual healing rates.
Alternatives
- Non-surgical treatments: physical therapy, braces, and medications.
- Alternative surgical procedures such as bone grafting or joint reconstruction.
- Pros of non-surgical treatments may include less immediate risk and no recovery from surgery; cons include potentially less effective long-term correction.
Patient Experience
Patients will be under anesthesia during the procedure and should not feel pain. Post-procedure, there may be discomfort, swelling, and limited movement in the forearm, which can be managed with pain medication and edema control measures. Physical therapy and gradual weight-bearing activities will be introduced as healing progresses.