Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process); with allograft
CPT4 code
Name of the Procedure:
Excision or Curettage of Bone Cyst or Benign Tumor of Radius or Ulna with Allograft
Summary
This procedure involves the surgical removal or scraping (curettage) of non-cancerous bone growths or cysts in the arm bones called the radius or ulna. After the abnormal bone is removed, the area is filled with bone graft material from a donor (allograft) to support healing and bone regeneration.
Purpose
This surgery is performed to address benign bone tumors or cysts in the radius or ulna that may cause pain, limit movement, or have the potential to weaken the bone and increase the risk of fractures. The goal is to remove the abnormal bone tissue, relieve symptoms, and restore normal bone function and structure.
Indications
- Persistent pain or discomfort in the arm
- Swelling or palpable mass in the radius or ulna
- Imaging studies indicating a benign bone tumor or cyst
- Risk of fracture due to weakened bone structure
- Restricted arm movement due to the presence of the cyst or tumor
Preparation
- Fasting for at least 6-8 hours before the procedure if general anesthesia is used.
- Adjustments or interruptions of certain medications as instructed by the surgeon, particularly blood thinners.
- Pre-surgical imaging tests, such as X-rays, MRI, or CT scans, to plan the procedure.
- Laboratory tests to assess overall health and surgical readiness.
Procedure Description
- Anesthesia is administered — generally, either general anesthesia or regional block.
- An incision is made over the site of the bone cyst or tumor.
- The abnormal bone tissue is carefully excised or scraped away using surgical tools.
- The resulting cavity is packed with allograft bone material, sourced from a donor.
- The incision is closed with sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes about 1 to 2 hours, depending on the size and complexity of the bone cyst or tumor.
Setting
The surgery is usually performed in a hospital or an outpatient surgical center.
Personnel
The procedure is conducted by an orthopedic surgeon, with support from surgical nurses, an anesthesiologist, and possibly a surgical assistant or technician.
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Non-union or delayed healing of the bone
- Anesthesia-related risks
- Allergic reaction to the allograft material
- Recurrence of the cyst or tumor
- Injury to surrounding nerves or blood vessels
Benefits
- Relief from pain and other symptoms associated with the bone cyst or tumor.
- Restoration of arm function and mobility.
- Strengthening of the bone to prevent fractures.
- Generally favorable outcomes with low recurrence when properly executed.
Recovery
- Post-procedure, the arm may be immobilized with a splint or cast.
- Pain management with prescribed medications.
- Keeping the surgical site clean and dry.
- Follow-up appointments for suture removal and monitoring of bone healing via imaging studies.
- Gradual return to normal activities over several weeks with possible physical therapy.
Alternatives
- Observation or regular monitoring if the cyst or tumor is asymptomatic and not causing any functional issues.
- Non-surgical options such as medication or steroid injections to manage symptoms.
- Risks of non-surgical alternatives include continued pain, risk of fracture, and potential growth of the cyst or tumor.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel any pain. Postoperatively, the patient may experience pain and swelling at the surgical site, which will be managed with medication. Full recovery can take several weeks, during which there may be some restrictions on arm movement and weight-bearing activities. Regular follow-ups will ensure proper healing and rehabilitation.