Name of the Procedure:

Osteoplasty, Carpal Bone, Shortening
Common Name(s): Carpal Bone Shortening Surgery

Summary

Osteoplasty for carpal bone shortening is a surgical procedure aimed at reshaping and reducing the length of one of the small bones in the wrist. This helps alleviate pressure and correct deformities.

Purpose

This procedure is typically performed to address wrist pain and functional issues caused by abnormal length of the carpal bones. The goal is to alleviate pain, restore proper wrist mechanics, and improve hand functionality.

Indications

• Persistent wrist pain not managed by nonsurgical methods
• Carpal instability
• Specific conditions such as Kienböck's disease or ulnar impaction syndrome
• Wrist deformities or chronic discomfort affecting daily activities

Preparation

• Patients may be required to fast for a certain period before the surgery
• Adjustments or cessation of certain medications as advised by the healthcare provider
• Pre-operative diagnostic tests like X-rays or MRI to plan the surgery
• Consultation with the surgeon to discuss the procedure and recovery process

Procedure Description

1. The patient is administered regional or general anesthesia.
2. An incision is made over the affected area of the wrist.
3. The surgeon reshapes and shortens the specified carpal bone using precision tools.
4. The bone is stabilized using screws or pins if necessary.

5. The incision is then closed with sutures, and a bandage or cast is applied.

   Duration

   The procedure typically takes about 1 to 2 hours, depending on the complexity.

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Radiologic technologists may assist for intraoperative imaging

Risks and Complications

• Infection at the surgical site
• Nerve or blood vessel damage
• Poor bone healing or nonunion
• Reduced wrist movement or stiffness
• Pain or discomfort during recovery
• Need for further surgery in rare cases

Benefits

• Relief from chronic wrist pain
• Improved wrist function and range of motion
• Correction of structural deformities
• Enhanced quality of life and daily functioning

Recovery

• Immobilization of the wrist for several weeks using a cast or splint
• Pain management via prescribed medication
• Gradual physical therapy to restore movement and strength
• Regular follow-up appointments to monitor healing
• Full recovery may take several months, with gradual improvement over time

Alternatives

• Non-surgical therapies, such as physical therapy and bracing
• Arthroscopic debridement of the wrist
• Medical management with anti-inflammatory medications
• Alternative surgical procedures depending on the specific wrist condition
• Pros and cons of these alternatives vary based on effectiveness, recovery time, and suitability for the patient

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, some discomfort, and swelling are expected, managed by pain relievers. Physical therapy will aid recovery, and patients should follow care instructions to facilitate proper healing.