Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process
CPT4 code
Name of the Procedure:
Partial Excision (Craterization, Saucerization, or Diaphysectomy) of Bone (e.g., Osteomyelitis), Olecranon Process
Summary
This procedure involves the surgical removal of a portion of bone from the olecranon process (part of the elbow) to treat infection or other bone disease. It helps to eradicate diseased tissue and promote healing.
Purpose
This procedure addresses bone infections such as osteomyelitis. The goal is to remove infected or necrotic bone tissue to prevent the spread of infection and facilitate healing.
Indications
- Persistent bone infection unresponsive to antibiotics
- Symptoms such as constant pain, swelling, and redness in the elbow area
- Diagnosis of osteomyelitis confirmed by imaging or biopsy
Preparation
- Fasting for at least 6 hours before surgery
- Adjustments or cessation of certain medications (as advised by the doctor)
- Preoperative blood tests and imaging studies (X-rays, MRI) to assess the extent of the infection
Procedure Description
- The patient is positioned and administered anesthesia.
- An incision is made over the olecranon process.
- Surgical instruments like curettes and drills are used to remove the infected bone.
- The area is thoroughly cleaned to eliminate all necrotic tissue.
- The incision is closed with sutures, and a sterile dressing is applied.
Equipment used may include surgical scalpels, drills, curettes, and specialized retractors.
Duration
Typically, 1 to 2 hours depending on the extent of the infection and tissue removal required.
Setting
This procedure is performed in a hospital operating room or surgical center.
Personnel
- Orthopedic surgeon or specialized surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technologists
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Damage to nearby structures (nerves or blood vessels)
- Delayed healing or non-healing of the site
- Anesthesia-related risks
Benefits
- Effective resolution of infection and associated symptoms
- Prevention of the spread of infection to other areas
- Potential for improved elbow function
Recovery
- Postoperative care includes keeping the surgical site clean and dry.
- Prescribed antibiotics and pain medication as needed.
- Follow-up appointments to monitor healing.
- Gradual return to activities, usually within 4-6 weeks, though full recovery may take longer.
Alternatives
- Long-term intravenous antibiotic therapy (less invasive but may be less effective for severe infections)
- Complete excision of the olecranon (more extensive, with longer recovery time)
- Hyperbaric oxygen therapy (adjunctive treatment)
Advantages and disadvantages should be discussed with the healthcare provider.
Patient Experience
During the procedure, the patient will be under anesthesia and will not experience pain. Postoperatively, they can expect some pain and swelling, managed with prescribed medications. Adequate pain management and adherence to recovery instructions will enhance comfort and facilitate healing.