25393 Osteoplasty, radius AND ulna; lengthening with autograft

Name of the Procedure:

Osteoplasty, Radius and Ulna Lengthening with Autograft

Summary

Osteoplasty of the radius and ulna involves surgical lengthening of these forearm bones using a bone graft taken from another part of the patient's body (autograft). This procedure is typically performed to correct bone deformities or discrepancies in length.

Purpose

This procedure addresses conditions where there is a discrepancy in the length of the radius and ulna, which can lead to functional impairments, pain, and difficulty in using the arm. The goal is to achieve proper alignment and length of the bones to restore normal function and alleviate symptoms.

Indications

• Congenital deformities resulting in unequal bone length
• Traumatic injuries leading to bone shortening or deformities
• Conditions causing bone growth disturbances, such as skeletal dysplasia
• Nonunion or malunion of fractures in the forearm

Preparation

• Patients may be required to fast for 8-12 hours before surgery.
• Medication adjustments may be necessary, especially for blood thinners.
• Preoperative diagnostic tests, including X-rays or CT scans, are required to plan the procedure.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made along the forearm to expose the radius and the ulna.
3. The bones are carefully cut to allow for lengthening.
4. Bone graft material is harvested from another site, commonly the pelvis.
5. The autograft is positioned between the cut bone segments.
6. Plates, screws, or other fixation devices are used to stabilize the graft.
7. The incision is closed with sutures or staples.

Duration

The procedure typically takes between 2 to 4 hours.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Infection
• Blood clots
• Nerve or blood vessel damage
• Nonunion or delayed healing of the bone
• Graft failure or rejection
• Complications related to anesthesia

Benefits

• Correction of bone length discrepancies
• Improved arm function
• Alleviation of pain and discomfort
• Enhanced quality of life

Recovery

• Post-operative care includes pain management, antibiotics, and wearing a splint or cast.
• Physical therapy may be required to restore mobility and strength.
• Recovery time varies but usually takes several months.
• Follow-up appointments for X-rays and progress monitoring.

Alternatives

• Use of external fixators for bone lengthening without grafts
• Synthetic bone graft material instead of autograft
• Conservative treatments like bracing and physical therapy, though less effective for significant discrepancies

Patient Experience

• Patients will experience some pain and swelling after surgery, managed with medications.
• There may be limited use of the affected arm during initial recovery.
• Regular follow-ups ensure proper healing and address any complications.