28120 Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus

Name of the Procedure:

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); talus or calcaneus

Summary

Partial excision of the talus or calcaneus involves the surgical removal of a portion of these bones to treat infections, tumors, or deformities. The procedure is designed to remove diseased bone tissue while preserving as much healthy bone structure as possible.

Purpose

This procedure addresses conditions like osteomyelitis (a bone infection) or abnormal bone growths (bossing). The goal is to eliminate the diseased part of the bone, relieve pain, and promote healing while maintaining the function of the foot.

Indications

• Chronic or acute osteomyelitis.
• Bone tumors or cysts.
• Abnormal bone growth or deformities causing pain or mobility issues.
• Failure of conservative treatments like antibiotics or immobilization.

Preparation

• Fasting for at least 8 hours before the procedure.
• Adjustments in medication, especially blood thinners.
• Preoperative imaging studies like X-rays, MRIs, or CT scans.
• Blood tests to assess overall health.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made over the affected area of the talus or calcaneus.
3. Specialized surgical tools are used to remove the diseased portion of the bone.
4. The remaining bone is smoothed to ensure proper healing and function.
5. If necessary, bone grafts or synthetic materials may be used to fill in the void left by the excision.
6. The incision is closed with sutures, and a dressing is applied.

Duration

The procedure typically takes 1 to 2 hours.

Setting

This surgery is usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic surgeon.
• Anesthesiologist.
• Surgical nurses and technicians.

Risks and Complications

• Infection.
• Bleeding.
• Nerve or blood vessel damage.
• Incomplete removal leading to recurrence of the problem.
• Delayed healing or non-union of the bone.

Benefits

• Relief from pain and infection.
• Improved foot function and mobility.
• Prevention of further bone damage.

Recovery

• Initial recovery in the hospital for monitoring.
• Pain management with prescribed medications.
• Use of crutches or a walker to avoid putting weight on the foot.
• Physical therapy to improve strength and mobility.
• Regular follow-up appointments with the surgeon.
• Full recovery can take several weeks to months depending on the extent of the surgery and the individual's healing rate.

Alternatives

• Long-term antibiotics for infection management.
• Conservative treatments like immobilization with casts or braces.
• Amputation in severe cases where bone preservation is not possible.
• Pros of alternatives: Less invasive, lower immediate surgical risks.
• Cons: May not be as effective in completely eliminating the problem, longer recovery for some options.

Patient Experience

During the surgery, the patient will be under general anesthesia and will not feel any pain. Post-operation, they may experience pain and swelling, managed with medications. Discomfort will gradually lessen, and mobility will improve with physical therapy and adherence to postoperative care instructions.