25390 Osteoplasty, radius OR ulna; shortening

Name of the Procedure:

Osteoplasty, radius OR ulna; shortening
Common name(s): Bone Shortening Surgery, Radius/Ulnar Shortening Osteoplasty

Summary

Osteoplasty of the radius or ulna is a surgical procedure that involves the removal of a small section of bone to shorten the radius or ulna. This procedure is typically performed to correct bone alignment issues or to relieve pain associated with certain wrist and forearm conditions.

Purpose

• Medical condition/problem addressed: This procedure is often performed to correct conditions like Madelung's deformity, ulnar impaction syndrome, or other congenital or acquired deformities where one of the bones in the forearm is too long in relation to the other.
• Goals/expected outcomes: The primary goal is to reduce pain, improve wrist function and alignment, and enhance the ability to perform daily activities.

Indications

• Specific symptoms/conditions: Chronic wrist pain, limited range of motion, and impaired wrist function that has not responded to non-surgical treatments.
• Patient criteria/factors: Patients experiencing significant ergonomic challenges or discomfort due to the disproportion of the forearm bones, verified through clinical evaluation and imaging studies.

Preparation

• Pre-procedure instructions: Patients may be required to fast for a certain period prior to surgery and may need to adjust or discontinue certain medications (such as blood thinners) as advised by the surgeon.
• Diagnostic tests/assessments: Preoperative imaging tests like X-rays, CT scans, or MRIs to understand the exact nature and extent of the bone deformity.

Procedure Description

1. Anesthesia: General anesthesia is commonly administered to ensure the patient remains unconscious and pain-free.
2. Incision: A surgical incision is made over the radius or ulna, depending on which bone requires shortening.
3. Bone Resection: Using specialized surgical tools, a section of the bone is removed.
4. Bone Shortening: The remaining bone ends are aligned and secured together, often using metal plates and screws.
5. Wound Closure: The incision is closed with sutures or surgical staples, and a sterile bandage is applied.

Duration

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

Setting

This surgery is usually performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Common risks: Infection, bleeding, and scarring.
• Rare risks: Nerve damage, delayed bone healing, nonunion of the bone, and chronic pain. Complications are usually managed with additional treatments or interventions as necessary.

Benefits

• Expected benefits: Reduction in pain, improvement in wrist function and range of motion, enhanced ability to perform daily and work-related activities.
• Timeframe for benefits: Patients may begin to notice improvements within a few weeks post-surgery, with optimal benefits typically realized after full recovery.

Recovery

• Post-procedure care: Patients may need to wear a cast or splint for several weeks to ensure proper healing. Pain management, physical therapy, and regular follow-up appointments are essential aspects of recovery.
• Expected recovery time: Full recovery may take several months, with specific duration varying based on the individual patient’s healing process and adherence to post-surgical care instructions.

Alternatives

• Other treatment options: Non-surgical treatments like physical therapy, anti-inflammatory medications, wrist splints, or activity modification.
• Pros and cons: Non-surgical options are less invasive with no recovery downtime but may be less effective for severe deformity cases. Surgery, though invasive, provides a more permanent solution for bone alignment issues.

Patient Experience

Patients can expect some discomfort and pain immediately after surgery, which is manageable with prescribed pain medications. Swelling and temporary limitations in wrist movement are common. Gradual improvements occur over weeks, facilitated by physical therapy and adherence to post-operative care.