24130 Excision, radial head

Name of the Procedure:

Excision, Radial Head

Summary

Excision of the radial head is a surgical procedure where the top part of the radius bone in the elbow (radial head) is removed. This is usually done to alleviate pain and restore motion when the radial head is damaged, fractured, or causing joint problems.

Purpose

This procedure addresses conditions such as severe fractures of the radial head, chronic pain, and limited motion due to previous injuries or arthritis. The goal is to relieve pain, improve joint function, and restore range of motion.

Indications

• Severe radial head fractures that cannot be repaired
• Chronic elbow pain due to arthritis or previous injuries
• Elbow stiffness impairing daily activities
• Failed previous surgeries involving the radial head

Preparation

• Patients may be asked to fast for 8 hours before surgery.
• Medication adjustments may be necessary, particularly blood thinners.
• Preoperative diagnostic tests may include X-rays, CT scans, or MRIs of the elbow.
• A complete medical history and physical examination are conducted.

Procedure Description

1. Anesthesia is administered, typically regional (nerve block) or general.
2. An incision is made over the elbow to access the joint.
3. The surgeon carefully removes the radial head while preserving surrounding structures.
4. The area is irrigated and checked for any additional damage.
5. The incision is closed with sutures, and a sterile bandage is applied.
6. The arm may be placed in a splint or sling for stabilization.

Duration

The procedure typically takes about 1-2 hours.

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurse or technician
• Operating room staff

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Stiffness or reduced range of motion
• Pain
• Need for additional surgeries
• Malalignment or instability of the elbow

Benefits

• Relief from chronic pain
• Improved elbow function and range of motion
• Quicker return to daily activities and work

Recovery

• Postoperative care includes pain management, usually with prescribed medications.
• Ice packs and elevation to reduce swelling.
• Physical therapy may begin shortly after surgery.
• Full recovery typically takes several weeks to months, depending on the individual's healing process.
• Follow-up appointments are essential to monitor progress.

Alternatives

• Non-surgical management, like physical therapy and medications.
• Radial head replacement with a prosthesis.
• Conservative management for minor fractures.
• Pros and cons: Surgery generally offers more definitive pain relief and functional improvement, while non-surgical options may result in prolonged symptoms or insufficient recovery.

Patient Experience

• During the procedure, patients under general anesthesia will be unconscious, while those with regional anesthesia will not feel pain but may be awake.
• After the procedure, patients might experience pain and swelling, manageable with prescribed pain relief and cold therapy.
• Physical therapy and regular exercises are crucial for restoration of elbow function and minimizing stiffness.

By providing all this detailed information, patients can better understand what to expect and make informed decisions about their care.