Name of the Procedure:

Carpectomy; 1 bone

• Common name: Carpectomy
• Technical/medical term: Partial Carpectomy

Summary

A Carpectomy is a surgical procedure that involves the removal of one of the small bones in the wrist, known as the carpal bones. This procedure aims to relieve pain and restore function to the wrist.

Purpose

The procedure aims to address wrist pain and mobility issues associated with damaged or diseased carpal bones. Expected outcomes include pain relief, improved wrist function, and a better quality of life.

Indications

• Chronic wrist pain unresponsive to other treatments
• Traumatic injury to a carpal bone
• Osteoarthritis or rheumatoid arthritis affecting a carpal bone
• Avascular necrosis of a carpal bone
• Severe carpal bone fractures or dislocations

Preparation

• Fasting for at least 6-8 hours before the procedure if general anesthesia will be used
• Stopping certain medications like blood thinners as advised by the doctor
• Preoperative imaging tests such as X-rays or MRI scans to assess the extent of the bone damage

Procedure Description

1. Anesthesia: The patient is administered local, regional, or general anesthesia depending on the complexity of the case.
2. Incision: A small incision is made over the affected area of the wrist.
3. Bone Removal: The targeted carpal bone is carefully removed using specialized surgical tools.
4. Closure: The incision is closed with sutures, and a bandage is applied.
5. Immobilization: The wrist may be immobilized with a splint or cast to facilitate healing.

Duration

The procedure typically takes about 1 to 1.5 hours.

Setting

• Hospital operating room
• Outpatient surgical center

Personnel

• Orthopedic surgeon or hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Prolonged pain or stiffness
• Reduced range of motion
• Anesthesia-related risks
• Non-union (failure of the bone to heal properly)

Benefits

Patients can expect significant pain relief and improved wrist function, usually becoming noticeable within weeks to a few months post-procedure.

Recovery

• Keeping the wrist elevated and icing the area to reduce swelling
• Pain management with prescribed medications
• Gradual wrist movements and physical therapy as recommended
• Follow-up appointments to monitor healing
• Typical recovery time ranges from 6 to 12 weeks, with some restrictions on wrist activities during this period

Alternatives

• Non-surgical treatments such as physical therapy, medications, and wrist splints
• Total wrist arthrodesis (joint fusion)
• Wrist arthroscopy Each option varies in invasiveness, recovery time, and effectiveness, and should be discussed with a doctor.

Patient Experience

• Patients may experience some discomfort and swelling initially after the procedure.
• Pain management strategies will be in place, including medications and physical therapy.
• Most patients report gradual improvement in pain and function over the weeks following surgery.