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Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft

CPT4 code

Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Carpal Bones with Allograft

  • Common Names: Bone Cyst/Tumor Removal, Allograft Surgery
  • Technical Term: Carpal Bone Cyst/Tumor Curettage with Allograft

Summary

This procedure involves the surgical removal (excision) or scraping out (curettage) of a non-cancerous bone cyst or tumor in the carpal bones (the small bones in the wrist), followed by filling the cavity with an allograft, which is a bone graft taken from a donor.

Purpose

  • Addressed Condition: Bone cysts or benign (non-cancerous) tumors in the carpal bones that may cause pain, swelling, or risk of fracture.
  • Goals: Remove the cyst or tumor, provide structural support using an allograft to promote proper healing, prevent recurrence, and restore normal function and strength to the wrist.

Indications

  • Persistent pain in the wrist
  • Swelling or a visible lump in the carpal bones
  • Risk of fracture or weakened wrist bones
  • Limitation in wrist movement
  • Diagnostic imaging (X-rays, MRI) confirming the presence of a bone cyst or benign tumor

Preparation

  • Pre-procedure Instructions: Fasting for at least 8 hours before surgery; adjust or stop certain medications as advised by your doctor.
  • Diagnostic Tests: Blood tests, imaging studies (X-rays, MRI), and possibly a biopsy to confirm the diagnosis.

Procedure Description

  1. Anesthesia: General anesthesia to keep you asleep and pain-free during the surgery.
  2. Incision: A small incision is made over the affected area of the wrist.
  3. Excision/Curettage: The surgeon removes the cyst or tumor using special surgical tools.
  4. Allograft Placement: The cavity left by the removal is filled with an allograft (donor bone tissue) to support healing and maintain bone strength.
  5. Closure: The incision is closed with sutures or surgical staples and covered with a sterile dressing.
  6. Post-procedure Imaging: X-ray to verify proper placement of the allograft.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity and size of the cyst or tumor.

Setting

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

Personnel

  • Orthopedic Surgeon
  • Anesthesiologist
  • Surgical Nurses
  • Surgical Technicians

Risks and Complications

  • Common Risks: Pain, swelling, infection at the surgical site, bleeding, or blood clots.
  • Rare Risks: Recurrent cyst/tumor, nerve damage, allergic reaction to anesthesia, graft rejection, delayed wound healing.

Benefits

  • Relief from pain and swelling
  • Restoration of normal wrist function and strength
  • Prevention of future fractures or complications
  • Enhanced quality of life
  • Benefits typically realized within a few weeks to months post-surgery.

Recovery

  • Post-procedure Care: Pain management with prescribed medications, keeping the wrist elevated, and wearing a splint or cast as advised.
  • Recovery Time: Several weeks to a few months, with activity restrictions.
  • Follow-up: Regular check-ups and imaging to monitor healing and graft integration.

Alternatives

  • Watchful Waiting: Monitoring the cyst or tumor if asymptomatic.
  • Non-surgical Treatments: Physical therapy or medication for pain management.
  • Other Surgical Options: Simple excision without graft, or using an autograft (patient's own tissue).
  • Pros/Cons: Non-surgical options may not resolve the condition but have fewer risks. Surgical alternatives depend on the specific case and patient health.

Patient Experience

  • During the Procedure: The patient will be under general anesthesia and will not feel anything.
  • After the Procedure: Expect some sore pain managed with medications; some discomfort and limited mobility are normal initially.
  • Pain Management: Oral pain relievers and anti-inflammatory medications as prescribed. Given instructions for incision care and activity restrictions for optimal recovery.

Medical Policies and Guidelines for Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft

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