28118 Ostectomy, calcaneus

Name of the Procedure:

Ostectomy, Calcaneus

Summary

An ostectomy of the calcaneus is a surgical procedure where part or all of the heel bone (calcaneus) is removed. This procedure is typically performed to treat various conditions that affect the heel bone, such as bone spurs, fractures, or deformities.

Purpose

The purpose of an ostectomy of the calcaneus is to alleviate pain, correct deformities, or remove damaged bone tissue in the heel. The goals are to improve mobility, relieve symptoms, and enhance the overall function of the foot.

Indications

• Chronic heel pain or plantar fasciitis that does not respond to conservative treatments
• Heel bone fractures that fail to heal properly
• Presence of bone spurs causing discomfort
• Structural deformities of the heel bone impacting mobility
• Infection or necrosis (dead tissue) in the heel bone

Preparation

• Patients may need to fast for 6-8 hours prior to the procedure.
• Certain medications, particularly blood thinners, might need to be adjusted or stopped.
• Preoperative imaging studies like X-rays, MRI, or CT scans will be performed to better assess the condition of the calcaneus.
• Patients will meet with the surgical team for a preoperative assessment.

Procedure Description

1. The patient is placed under general or regional anesthesia.
2. An incision is made over the heel to access the calcaneus.
3. Specialized surgical instruments are used to remove the damaged or deformed bone.
4. If necessary, hardware like screws or plates may be used to stabilize any remaining bone.
5. The incision is closed with sutures, and a sterile dressing is applied.
6. The foot may be placed in a cast or surgical boot to protect the area during initial healing.

Duration

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

Setting

The procedure is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection
• Blood clots
• Nerve damage or numbness
• Prolonged pain or discomfort
• Healing difficulties, particularly in patients with underlying conditions like diabetes
• Recurrence of bone issues

Benefits

• Alleviation of chronic heel pain
• Correction of deformities and improved foot function
• Enhanced mobility and quality of life
• Reduced risk of further complications in the heel area

Recovery

• Patients may need to keep weight off the affected foot for several weeks.
• Crutches or a walker may be necessary for mobility during the initial recovery phase.
• Follow-up appointments are needed to monitor healing and remove sutures.
• Physical therapy might be recommended to strengthen the foot and improve function.
• Complete recovery typically takes 6 to 12 weeks, though this can vary based on the individual case and overall health.

Alternatives

• Conservative treatments such as physical therapy, custom orthotics, corticosteroid injections, and medications.
• Less invasive surgical options like endoscopic procedures to address specific issues like bone spurs.
• Pros and Cons:
  • Conservative treatments are non-invasive but may not be effective for severe conditions.
  • Endoscopic procedures may have a quicker recovery but might not be suitable for complex deformities.

Patient Experience

• During the procedure, patients are under anesthesia and should not experience pain.
• Post-operatively, patients might experience discomfort, which can be managed with prescribed pain medications.
• Patients need to follow specific care instructions to optimize healing and prevent complications.
• Physical therapy and gradual return to regular activities play a crucial role in recovery and overall outcomes.