28304 Osteotomy, tarsal bones, other than calcaneus or talus

Name of the Procedure:

Osteotomy, tarsal bones, other than calcaneus or talus

Summary

An osteotomy of the tarsal bones involves surgically cutting and reshaping bones in the midfoot (excluding the calcaneus and talus bones) to correct deformities, improve function, or alleviate pain.

Purpose

This procedure addresses conditions such as flat feet (pes planus), cavus foot (high arches), or other deformities and misalignments of the midfoot. The primary goals are to correct structural abnormalities, relieve pain, and restore normal foot function.

Indications

• Severe flatfoot or high arch deformities
• Midfoot arthritis causing significant pain
• Traumatic injury leading to bone deformity
• Neuromuscular disorders affecting foot structure
• Unsatisfactory results from conservative treatments (e.g., orthotics, physical therapy)

Preparation

• Patients may need to fast for at least 8 hours before surgery.
• Medication adjustments may be necessary; certain medications need to be paused.
• Diagnostic tests such as X-rays, MRI, or CT scans to assess the extent and precise location of the deformity.

Procedure Description

1. The patient is given regional or general anesthesia to prevent pain during the surgery.
2. The surgeon makes an incision over the affected area of the midfoot.
3. Special surgical tools are used to cut and reposition the bone(s) as needed.
4. Small plates, screws, or pins may be used to stabilize the bone in its new position.
5. The incision is closed with sutures, and a sterile dressing is applied.
6. A cast or splint is often used to immobilize the foot during initial healing.

Duration

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

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection at the surgical site
• Nerve damage
• Blood clots
• Incomplete healing or poor bone alignment
• Persistent pain or discomfort
• Need for revision surgery

Benefits

• Improved foot alignment and function
• Significant pain relief
• Enhanced mobility and stability
• Better quality of life due to reduced symptoms

Recovery

• Initial recovery involves keeping the foot elevated and limiting weight-bearing activities.
• Follow-up appointments for wound checks and cast or splint changes.
• Physical therapy may be recommended to strengthen the foot and improve function.
• Full recovery can take several months, and patients might be advised to avoid strenuous activities during this period.

Alternatives

• Nonsurgical treatments (e.g., orthotics, physical therapy)
• Limited arthrodesis (joint fusion)
• Conservative management with lifestyle modifications
• Each alternative has its pros and cons, with surgery generally providing more definitive correction but carrying higher risks.

Patient Experience

During the procedure, the patient will be under anesthesia, so they will not feel anything. Postoperatively, some pain and swelling are expected, managed with pain medication and rest. Discomfort should gradually decrease as healing progresses, with improvements typically noticeable within a few weeks to months.