28024 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint

Name of the Procedure:

Arthrotomy; also known as joint incision and exploration, drainage, or removal of loose or foreign body; specifically targeted at the interphalangeal joint.

Summary

An arthrotomy is a surgical procedure involving an incision into a joint, most commonly to explore, drain fluid, or remove loose or foreign bodies. This particular type focuses on the interphalangeal joints found in the fingers or toes.

Purpose

Arthrotomy addresses joint issues caused by infection, inflammation, or trauma. The goals are to alleviate pain, remove foreign bodies or loose debris, drain excess fluid, and restore joint function.

Indications

• Persistent joint pain or swelling not responding to conservative treatments
• Presence of loose bodies or foreign material within the joint
• Joint infections or effusions that need drainage
• Decreased joint mobility or function due to impediments inside the joint

Preparation

• Patients may need to fast for several hours before surgery.
• Adjustments to medications, particularly blood thinners, might be necessary.
• Pre-procedure imaging studies (X-rays/MRI) or blood tests could be required.

Procedure Description

1. The patient is placed under local or general anesthesia.
2. A surgical incision is made over the interphalangeal joint.
3. The surgeon explores the joint space, using specialized instruments to locate and remove any loose or foreign bodies or to drain fluid.
4. The joint is irrigated to ensure cleanliness.
5. The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes 30 minutes to 1 hour, depending on the complexity.

Setting

Arthrotomies are usually performed in a hospital operating room or an outpatient surgical center.

Personnel

The procedure involves a team consisting of:

• A surgeon (orthopedic or general)
• An anesthesiologist (if general anesthesia is used)
• Surgical nurses and technician

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Damage to surrounding tissues or nerves
• Stiffness or decreased range of motion in the joint
• Adverse reactions to anesthesia

Benefits

• Relief from joint pain and swelling
• Enhanced joint function and mobility
• Removal of impediments within the joint
• Prevention or treatment of joint infections

Recovery

• Patients may need to limit the use of the affected joint for a few days.
• Pain relief medications and antibiotics might be prescribed.
• Follow-up appointments for wound check and suture removal, typically within 1-2 weeks.
• Physical therapy could be recommended to restore joint function.

Alternatives

• Non-surgical treatments such as physical therapy, medication, or joint injections.
• Arthroscopy, a less invasive procedure using a camera and instruments inserted through small incisions.
• Each alternative has its own benefits and limitations which should be discussed with the healthcare provider.

Patient Experience

• During the procedure, patients under local anesthesia might feel pressure but should not experience pain; those under general anesthesia will be unconscious.
• Post-procedure, some pain or discomfort is expected, which can be managed with prescribed pain relievers.
• Proper care and adherence to post-operative instructions promote a smoother recovery process.