26236 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger

Name of the Procedure:

Partial excision of bone (craterization, saucerization, or diaphysectomy) in the distal phalanx of a finger.

Summary

Partial excision, also known as craterization, saucerization, or diaphysectomy, involves the surgical removal of a portion of the bone in the distal phalanx of the finger. This procedure is typically used to treat bone infections or other bone abnormalities in the finger.

Purpose

Partial excision aims to remove infected or damaged bone tissue to prevent the spread of infection, alleviate pain, and promote healing. It's primarily used for conditions such as osteomyelitis (bone infection).

Indications

• Persistent bone infections that don't respond to antibiotics (osteomyelitis).
• Chronic pain or dysfunction in the distal phalanx due to bone abnormalities.
• Other bone conditions necessitating the removal of damaged tissue.

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-procedure diagnostic tests such as X-rays or MRI might be required to assess the condition of the bone.

Procedure Description

1. Anesthesia: The procedure usually begins with the administration of local anesthesia, and in some cases, general anesthesia may be used.
2. Incision: A small incision is made over the distal phalanx of the affected finger.
3. Bone Removal: Specialized surgical instruments are used to remove the infected or damaged portion of the bone.
4. Cleaning and Debridement: The area is cleaned thoroughly to remove any remaining infected tissue.
5. Closure: The incision is closed using sutures or surgical glue.
6. Dressing: The finger is dressed to protect the surgical site.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

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

Personnel

• Orthopedic or general surgeon
• Surgical nurse
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Non-union or delayed healing of the bone
• Recurrence of infection

Benefits

• Removal of infected or damaged bone tissue
• Relief from pain and discomfort
• Prevention of further spread of infection
• Improved function of the affected finger

Recovery

• Post-procedure instructions include keeping the finger clean and dry.
• Pain management may involve prescribed pain medications.
• The patient might need to wear a splint or bandage.
• Follow-up appointments to monitor healing.
• Recovery time varies but typically ranges from a few weeks to a few months, depending on the severity of the initial condition.

Alternatives

• Antibiotic therapy
• Conservative management with anti-inflammatory medications and rest.
• Amputation of the distal phalanx in severe or unresponsive cases.

Patient Experience

During the procedure, the patient typically will not feel pain due to anesthesia, although they may feel pressure or movement. Post-procedure, pain management will be addressed with medications, and discomfort is expected to subside as healing progresses. The patient will need to follow specific care instructions to ensure proper recovery.