Amputation, thigh, through femur, any level; secondary closure or scar revision
CPT4 code
Name of the Procedure:
Amputation, thigh, through femur, any level; secondary closure or scar revision.
Summary
In this procedure, a portion of the thigh bone (femur) and surrounding tissue is surgically removed, often followed by a secondary closure or revision of the scar to improve healing and function.
Purpose
The procedure addresses severe trauma, infection, tumors, or other conditions that damage the thigh and femur. The goal is to remove diseased or non-viable tissue to prevent further complications and to prepare the patient for eventual prosthetic fitting or improved quality of life.
Indications
- Severe traumatic injury to the thigh and femur
- Infections that do not respond to antibiotic treatment
- Bone cancer or other tumors in the femur
- Chronic non-healing wounds or ulcers
- Poor circulation resulting in gangrene
Preparation
- Pre-surgical evaluation and medical clearance
- Diagnostic imaging like X-rays or MRI
- Blood tests and possibly a pre-operative physical exam
- Fasting for 8-12 hours before surgery
- Adjustments or discontinuation of certain medications, like blood thinners
Procedure Description
- Under anesthesia, an incision is made in the thigh.
- The femur is surgically sawed through at the predetermined level.
- Soft tissues (muscles, blood vessels, nerves) are carefully managed and severed.
- The wound is cleansed, and a secondary closure technique is applied or a scar is revised.
- The remaining tissue is shaped to accommodate a future prosthesis.
- The surgical site is closed with sutures, and a sterile dressing is applied.
Duration
The procedure typically takes 2-4 hours.
Setting
It is performed in a hospital operating room under sterile conditions.
Personnel
- Orthopedic or general surgeon
- Anesthesiologist
- Surgical nurses
- Surgical technologists
Risks and Complications
- Common risks: Infection, bleeding, blood clots
- Rare risks: Nerve damage, long-term pain (phantom limb pain), complications from anesthesia, poor wound healing
- Complications: Non-healing wound, need for further surgery
Benefits
- Removal of diseased or damaged tissue
- Prevention of further infection or complications
- Improved potential for prosthetic use
- Enhanced quality of life and functionality
Recovery
- Hospital stay of a few days to a week
- Pain management with prescribed medications
- Wound care and monitoring for signs of infection
- Physical therapy and potential prosthetic fitting
- Follow-up appointments for wound checks and overall health
- Full recovery can take several months
Alternatives
- Limb-sparing surgery (if possible)
- Intensive antibiotic therapy (for infections)
- Radiation therapy or chemotherapy (for tumors)
- Pros of alternatives: Potential avoidance of amputation
- Cons: May not be as effective in removing diseased tissue, more extended treatment periods
Patient Experience
During the procedure, patients are under general anesthesia and will not feel any pain. Post-procedure, there may be discomfort and pain managed through medications. Physical therapy is crucial to regain mobility and prepare for prosthetic use, and emotional support is also essential to adapt to life after amputation.