Name of the Procedure:

Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body.

Summary

An arthrotomy of the radiocarpal or midcarpal joint is a surgical procedure in which an incision is made into the joint to explore the area, drain any excess fluids, or remove foreign bodies that may be causing pain or dysfunction.

Purpose

This procedure addresses joint abnormalities in the wrist, commonly related to infections, inflammation, injuries, or the presence of foreign objects. The goals are to relieve pain, reduce inflammation, clear infections, remove problematic debris, and restore normal joint function.

Indications

• Persistent pain or swelling in the wrist.
• Joint infections (septic arthritis).
• Presence of foreign objects or debris in the joint.
• Injuries causing joint disruption.
• Failure of conservative treatments for joint issues.

Preparation

• Patients may be instructed to fast for 8-12 hours prior to surgery.
• Adjust or pause certain medications, particularly blood thinners, as advised by the physician.
• Preoperative imaging studies like X-rays, MRI, or CT scans to assess the joint condition.
• Blood tests to check for infections or other concerns.

Procedure Description

1. The patient is given anesthesia—local, regional, or general—depending on the extent of the procedure.
2. An incision is made over the affected joint area.
3. The surgeon carefully explores the joint to identify and address the issue.
4. Any foreign bodies are removed, infected or inflamed tissue is drained, and the joint is thoroughly examined.
5. The incision is closed with sutures, and a sterile dressing is applied.
6. In some cases, a drain may be placed temporarily to allow for continued drainage of fluids.

Duration

The procedure typically takes 1-2 hours, depending on the complexity and extent of the surgery.

Setting

This procedure is usually performed in a hospital operating room or an outpatient surgical center with appropriate facilities.

Personnel

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

Risks and Complications

• Infection
• Bleeding
• Nerve or blood vessel damage
• Joint stiffness
• Recurrent issues requiring further intervention
• Adverse reactions to anesthesia

Benefits

• Relief from pain and inflammation.
• Resolution of infections.
• Removal of foreign objects or debris.
• Restoration of normal joint function.
• Improved wrist movement and overall hand function.

Recovery

• Patients may need to wear a splint or cast to immobilize the wrist.
• Pain management with prescribed medications.
• Physical therapy may be needed to restore movement and strength.
• Recovery time varies from a few weeks to several months depending on the extent of the surgery.
• Follow-up appointments to monitor healing and progress.

Alternatives

• Non-surgical treatments like medications, splinting, or physical therapy.
• Arthroscopy, a minimally invasive procedure using a camera and smaller incisions.
• Lifestyle modifications and ergonomic adjustments to reduce joint strain. Compared to arthrotomy, these alternatives may be less invasive but might not be as effective for certain conditions.

Patient Experience

• During the procedure, the patient will be under anesthesia and will not feel any pain.
• Postoperatively, the patient may experience discomfort, swelling, and limited mobility.
• Pain management will include medications and ice applications.
• Patients should follow the surgeon’s instructions for care and activity restrictions to ensure proper healing.