25900 Amputation, forearm, through radius and ulna

Name of the Procedure:

Amputation, Forearm, through Radius and Ulna
Common name(s): Forearm Amputation
Medical term: Transradial Amputation

Summary

A forearm amputation through the radius and ulna involves surgically removing part of the forearm below the elbow joint. This procedure is often performed to address severe trauma, infection, or disease that affects the lower part of the arm.

Purpose

This procedure is conducted to remove damaged, diseased, or non-functional tissue from the forearm that cannot be salvaged. The goals include alleviating pain, preventing the spread of infection, and improving the patient's quality of life by allowing the use of a prosthetic limb.

Indications

• Severe trauma with irreparable damage to the forearm
• Intractable infections or severe osteomyelitis
• Malignant tumors or aggressive benign tumors of the forearm
• Severe vascular disease leading to non-viable tissue
• Congenital anomalies that severely impair function

Preparation

• Patient will undergo a thorough medical evaluation, including blood tests and imaging studies (e.g., X-rays, MRI).
• Pre-surgical fasting for at least 8 hours.
• Adjustments to current medications, as directed by the surgical team.
• Hygiene preparation, including preoperative cleansing of the surgical site.
• Psychological counseling may be recommended to help the patient cope with the loss of a limb.

Procedure Description

1. The patient is positioned supine on the operating table.
2. General anesthesia is administered.
3. An incision is made in the skin and soft tissues to expose the radius and ulna.
4. The bones are carefully cut, and blood vessels and nerves are managed by ligation or cauterization to prevent excessive bleeding and ensure proper healing.
5. The muscles are contoured to cover the bone ends, and the skin is then closed with sutures.
6. A sterile dressing is applied to the surgical site, and a postoperative splint or cast may be used to immobilize the area.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Lead Surgeon
• Surgical Assistants
• Anesthesiologist
• Operating Room Nurses
• Surgical Technicians

Risks and Complications

• Infection at the surgical site
• Excessive bleeding or blood clots
• Phantom limb pain
• Delayed wound healing
• Scar tissue formation, possibly affecting prosthesis fitting
• Nerve damage causing loss of sensation or motor function

Benefits

• Removal of diseased or damaged tissue
• Pain relief
• Prevention of further complications (e.g., spread of infection)
• Improved mobility and functionality with the future use of a prosthesis

Recovery

• Patients will receive pain management medications.
• Wound care instructions and frequent dressing changes will be necessary.
• Physical therapy to strengthen the remaining limb and to adapt to using a prosthesis.
• Initial recovery typically takes 4-6 weeks, but rehabilitation can extend to several months.
• Regular follow-up appointments to monitor healing and to fit a prosthesis.

Alternatives

• Limb-salvage procedures, if viable
• Reconstructive surgery
• Conservative treatments (e.g., medications, physical therapy) for less severe conditions
• Each alternative has varying pros and cons, and the feasibility will depend heavily on the specific medical condition of the patient.

Patient Experience

• During the procedure, the patient will be under anesthesia and feel no pain.
• Post-surgery, expect some pain and discomfort managed with medications.
• The patient might experience emotional distress due to the loss of a limb, and psychological support is often recommended.
• Activities may be restricted initially, but gradual improvements and adaptation with a prosthesis will enhance daily functioning.