Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius
CPT4 code
Name of the Procedure:
Partial Excision (Craterization, Saucerization, or Diaphysectomy) of Bone (e.g., for Osteomyelitis); Radius
Summary
Partial excision of the radius bone involves surgically removing a portion of the bone affected by infection or damage. This is often done to treat osteomyelitis, an infection of the bone. Techniques like craterization, saucerization, or diaphysectomy may be used to clean and excise the infected area.
Purpose
This procedure addresses osteomyelitis, a severe bone infection that can damage bone tissue. The primary goal is to remove infected or dead bone, allowing healthy bone to heal and preventing the spread of infection. It aims to reduce pain and improve function in the affected limb.
Indications
- Persistent bone pain and tenderness
- Signs of bone infection, such as swelling, redness, and warmth
- Failure of non-surgical treatments like antibiotics
- Chronic osteomyelitis not responsive to medical management
Preparation
- Fasting for several hours before surgery
- Adjusting current medications, especially blood thinners
- Preoperative imaging studies like X-rays or MRI
- Blood tests to assess overall health and readiness for surgery
Procedure Description
- The patient receives anesthesia to ensure comfort, typically general anesthesia.
- An incision is made over the radius to access the affected bone.
- The surgeon identifies and removes the infected or dead portion of the bone using specialized surgical tools.
- Depending on the technique, the bone may be craterized (creating a concave area), saucerized (forming a saucer-like shape), or a diaphysectomy (removing a segment of the bone).
- The surgical site is cleaned, and any necessary bone or tissue cultures are taken.
- The wound is closed using sutures or staples, and a sterile dressing is applied.
Duration
The procedure typically takes 1 to 2 hours, depending on the extent of the infection and the complexity of the surgery.
Setting
Performed in a hospital operating room, sometimes in an outpatient surgical center for less complex cases.
Personnel
- Orthopedic surgeon
- Surgical nurses
- Anesthesiologist
- Surgical technician
Risks and Complications
- Infection
- Bleeding
- Nerve or blood vessel injury
- Non-union or poor healing of the bone
- Need for further surgery if infection persists
Benefits
- Removal of infected or necrotic bone tissue
- Reduction of pain and discomfort
- Prevention of further spread of infection
- Improved limb function and mobility
- Healing of healthy bone tissue
Recovery
- Hospital stay for 1-2 days for observation
- Pain management with prescribed medications
- Instructions on keeping the wound clean and dry
- Limited use of the affected limb for several weeks
- Follow-up appointments for wound checks and potentially physical therapy
- Full recovery may take several weeks to months
Alternatives
- Long-term antibiotic therapy without surgery
- Hyperbaric oxygen therapy
- Bone grafting, if a significant portion of bone is removed
- Amputation in extreme cases where infection cannot be controlled
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel pain. Post-surgery, pain and discomfort can be managed with prescribed medications. Initial pain and swelling are common but should subside with proper care. The patient may need to avoid heavy lifting or strenuous activity until fully healed, with mobility aids like slings or splints used as needed. Regular follow-up visits will monitor healing and address any complications.