Name of the Procedure:

Anesthesia for Open or Surgical Arthroscopic Procedures of the Elbow; Repair of Nonunion or Malunion of Humerus

Summary

This procedure involves administering anesthesia to facilitate the surgical repair of a humerus that either has not healed (nonunion) or has healed incorrectly (malunion). This surgery could be done as an open procedure or using arthroscopy, which is a minimally invasive technique involving small incisions and the use of a camera.

Purpose

The purpose is to provide adequate pain relief and sedation during the surgical repair of the humerus. The goal is to ensure the patient remains comfortable and still, allowing the surgeon to correct the bone deformity and restore proper function to the elbow.

Indications

• Persistent pain and impaired function due to nonunion or malunion of the humerus.
• Visible deformity or misalignment of the elbow.
• Failed previous treatments to correct the bone healing issue.
• Patient is medically fit for surgery and anesthesia.

Preparation

• Fasting for at least 6-8 hours before the procedure.
• Temporary discontinuation or adjustment of certain medications as advised by the physician.
• Pre-operative tests such as blood work, X-rays, or MRI scans to assess the condition and plan the surgery.
• Discussion with the anesthesiologist about anesthesia options and medical history.

Procedure Description

1. Anesthesia Administration: The patient is brought to the operating room and connected to monitoring equipment. The anesthesiologist administers anesthesia, which may be general (putting the patient to sleep) or regional (numbing just the area around the elbow).
2. Surgical Approach: For an open procedure, the surgeon makes an incision to directly access the humerus. For arthroscopy, small incisions are made for the camera and instruments.
3. Repair: The surgeon realigns the bone, removes any scar tissue, and may use screws, plates, or rods to stabilize it.
4. Closure: The incisions are closed with sutures or staples.
5. Recovery Room: The patient is monitored as they wake up from anesthesia.

Duration

The procedure typically takes 2-3 hours, depending on the complexity of the case.

Setting

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

Personnel

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

Risks and Complications

• Common risks: Nausea, vomiting, dizziness, pain at the injection site, sore throat from a breathing tube.
• Rare risks: Allergic reactions to anesthesia, infection, blood clots, nerve damage, complications with bone healing.
• Management: Monitoring and medications are used to manage and mitigate risks.

Benefits

• Relief from pain.
• Restoration of normal elbow function and alignment.
• Enhanced quality of life and ability to perform daily activities.
• Benefits are often realized within weeks to months post-surgery.

Recovery

• Initial recovery involves rest and limited movement of the elbow.
• Physical therapy starts soon after surgery to restore mobility and strength.
• Full recovery might take several weeks to months.
• Follow-up appointments are necessary to monitor healing progress.
• Restrictions on heavy lifting and strenuous activity during the recovery period.

Alternatives

• Non-surgical treatments: Physical therapy, bracing, medication for pain management.
• Pros: Non-invasive, lower risk.
• Cons: May not be effective for severe nonunion or malunion, longer healing time.
• Surgical alternatives: Different surgical techniques based on specific conditions.

Patient Experience

• During: The patient will be under anesthesia and should not feel pain during the procedure.
• After: Expect some pain and swelling, managed with medications. Discomfort typically improves over days to weeks.
• Regular pain management and comfort measures are employed, including the use of ice, elevation, and prescribed painkillers.