Osteotomy, radius; distal third
CPT4 code
Name of the Procedure:
Osteotomy, radius; distal third
Common name(s): Distal radius osteotomy
Summary
In layman's terms, a distal radius osteotomy is a surgical procedure where the surgeon cuts and repositions the lower part of the radius bone (one of the bones of the forearm) near the wrist. The goal is to correct bone deformities or injuries to restore proper function and alleviate pain.
Purpose
This procedure addresses conditions such as malunited fractures (healed fractures that didn't align correctly), congenital bone deformities, or other wrist abnormalities. The goals are to improve wrist alignment, enhance functionality, and reduce pain.
Indications
- Malunited distal radius fractures
- Congenital deformities of the radius
- Persistent wrist pain with functional impairment
- Abnormal wrist mechanics affecting daily activities
Preparation
- Fasting: Typically, the patient must fast for at least 8 hours before surgery.
- Medication adjustments: Patients may need to stop certain medications such as blood thinners.
- Diagnostic tests: X-rays, MRI, or CT scans to assess the extent of the deformity and plan the surgical approach.
Procedure Description
- Anesthesia: General anesthesia or regional anesthesia (nerve block) is administered.
- Incision: A surgical cut is made over the distal third of the radius.
- Cutting and Repositioning: The surgeon uses specialized tools to cut the bone and realign it into the correct position.
- Fixation: The repositioned bone is secured using plates, screws, or pins.
- Closure: The incisions are closed with sutures, and a sterile dressing is applied.
Duration
The procedure usually takes about 1-2 hours, depending on the complexity of the case.
Setting
This surgery is typically performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist or nurse anesthetist
- Surgical nurses
- Radiologic technicians (if imaging is needed during the procedure)
Risks and Complications
- Infection
- Bleeding
- Nerve or blood vessel damage
- Nonunion or delayed union of the bone
- Hardware irritation or failure
- Loss of wrist motion or stiffness
Benefits
- Improved wrist alignment and function
- Reduction in pain
- Enhanced ability to perform daily activities
- Correction of deformities leading to better cosmetic appearance
Recovery
- Post-op care: Keep the surgical site clean and dry, follow dressing care instructions.
- Pain management: Pain medications as prescribed.
- Activity: Limited wrist movement initially, gradually increasing as healing progresses.
- Physical therapy: Often required to restore full function.
- Follow-up: Regular appointments to monitor healing and adjust treatment as necessary.
Alternatives
- Non-surgical management: Bracing, physical therapy, and medications.
- Other surgical options: Joint fusion or joint replacement in severe cases.
- Pros and cons: Non-surgical options may not fully correct the deformity, delayed surgical options may lead to worsening conditions.
Patient Experience
During the procedure, the patient will be under anesthesia and won't feel pain. Post-surgery, patients might experience discomfort, swelling, and limited motion, managed with painkillers and immobilization devices. Recovery involves gradual rehabilitation with physical therapy for a few weeks to months until full function is restored.