Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)
CPT4 code
Name of the Procedure:
Incision, bone cortex, hand or finger (e.g., osteomyelitis or bone abscess)
Summary
An incision in the bone cortex of the hand or finger is a surgical procedure to access and treat infected or damaged bone tissue, usually due to conditions like osteomyelitis (bone infection) or a bone abscess.
Purpose
Medical Condition:
- Osteomyelitis
- Bone abscess
Goals/Outcomes:
- To remove infected or necrotic bone tissue
- To drain abscesses
- To promote healing and restore function
Indications
Symptoms/Conditions:
- Persistent pain in the affected bone
- Swelling or redness over the bone
- Fever or chills indicating infection
- Non-healing wounds over the bone area
Patient Criteria:
- Confirmed diagnosis of osteomyelitis or bone abscess via imaging or lab tests
- Failure of non-surgical treatments, such as antibiotics
Preparation
Instructions:
- Fasting 6-8 hours prior to the procedure if anesthesia is used
- Adjusting or stopping certain medications as directed by the healthcare provider
- Reviewing medical history and preoperative assessment
Diagnostic Tests:
- Blood tests
- X-rays, MRI, or CT scans
- Bone biopsy in some cases
Procedure Description
Steps:
- Administration of local or general anesthesia.
- Making an incision over the affected bone area.
- Carefully cutting into the bone cortex to access the deeper bone tissue.
- Removing infected or dead bone tissue.
- Draining any abscess and potentially inserting a drain.
- Irrigating the area with a sterile solution.
- Closing the incision with sutures or staples.
Tools/Equipment:
- Scalpel
- Bone drills or saws
- Irrigation and suction equipment
- Surgical drains (if needed)
Anesthesia:
- Local anesthesia for minor procedures.
- General anesthesia for more extensive surgery.
Duration
Typically, 1-2 hours, depending on the severity of the infection and the specific surgical approach.
Setting
Performed in a hospital operating room or specialized surgical center.
Personnel
- Orthopedic surgeon (or hand surgeon)
- Surgical nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
Common Risks:
- Infection
- Bleeding
- Pain at the incision site
Rare Complications:
- Damage to nearby nerves or tissues
- Nonunion or improper healing of the bone
- Recurrence of infection
Benefits
- Resolution of infection
- Relief from pain and swelling
- Improved function and mobility of the affected hand or finger
Recovery
Post-Procedure Care:
- Keeping the incision clean and dry
- Pain management with prescribed medications
- Antibiotics to prevent or treat infection
Recovery Time:
- Initial healing typically takes a few weeks.
- Full recovery and return to normal activities may take several months.
Follow-Up:
- Regular check-ups to monitor healing
- Possible physical therapy
Alternatives
Options:
- Intravenous antibiotic therapy
- Hyperbaric oxygen therapy
- Use of advanced wound care and dressings
Pros and Cons:
- Non-surgical treatments may take longer and be less effective for severe cases.
- Surgery provides direct access to the infected area, allowing for thorough cleaning and faster relief.
Patient Experience
During Procedure:
- Under anesthesia, the patient should feel minimal to no pain.
After Procedure:
- Some discomfort and swelling at the incision site
- Pain managed with medications
- Gradual improvement in symptoms as healing progresses