Name of the Procedure:

Incision, bone cortex, hand or finger (e.g., osteomyelitis or bone abscess)

Summary

An incision in the bone cortex of the hand or finger is a surgical procedure to access and treat infected or damaged bone tissue, usually due to conditions like osteomyelitis (bone infection) or a bone abscess.

Purpose

Medical Condition:

• Osteomyelitis
• Bone abscess

Goals/Outcomes:

• To remove infected or necrotic bone tissue
• To drain abscesses
• To promote healing and restore function

Indications

Symptoms/Conditions:

• Persistent pain in the affected bone
• Swelling or redness over the bone
• Fever or chills indicating infection
• Non-healing wounds over the bone area

Patient Criteria:

• Confirmed diagnosis of osteomyelitis or bone abscess via imaging or lab tests
• Failure of non-surgical treatments, such as antibiotics

Preparation

Instructions:

• Fasting 6-8 hours prior to the procedure if anesthesia is used
• Adjusting or stopping certain medications as directed by the healthcare provider
• Reviewing medical history and preoperative assessment

Diagnostic Tests:

• Blood tests
• X-rays, MRI, or CT scans
• Bone biopsy in some cases

Procedure Description

Steps:

1. Administration of local or general anesthesia.
2. Making an incision over the affected bone area.
3. Carefully cutting into the bone cortex to access the deeper bone tissue.
4. Removing infected or dead bone tissue.
5. Draining any abscess and potentially inserting a drain.
6. Irrigating the area with a sterile solution.
7. Closing the incision with sutures or staples.

Tools/Equipment:

• Scalpel
• Bone drills or saws
• Irrigation and suction equipment
• Surgical drains (if needed)

Anesthesia:

• Local anesthesia for minor procedures.
• General anesthesia for more extensive surgery.

Duration

Typically, 1-2 hours, depending on the severity of the infection and the specific surgical approach.

Setting

Performed in a hospital operating room or specialized surgical center.

Personnel

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

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Pain at the incision site

Rare Complications:

• Damage to nearby nerves or tissues
• Nonunion or improper healing of the bone
• Recurrence of infection

Benefits

• Resolution of infection
• Relief from pain and swelling
• Improved function and mobility of the affected hand or finger

Recovery

Post-Procedure Care:

• Keeping the incision clean and dry
• Pain management with prescribed medications
• Antibiotics to prevent or treat infection

Recovery Time:

• Initial healing typically takes a few weeks.
• Full recovery and return to normal activities may take several months.

Follow-Up:

• Regular check-ups to monitor healing
• Possible physical therapy

Alternatives

Options:

• Intravenous antibiotic therapy
• Hyperbaric oxygen therapy
• Use of advanced wound care and dressings

Pros and Cons:

• Non-surgical treatments may take longer and be less effective for severe cases.
• Surgery provides direct access to the infected area, allowing for thorough cleaning and faster relief.

Patient Experience

During Procedure:

• Under anesthesia, the patient should feel minimal to no pain.

After Procedure:

• Some discomfort and swelling at the incision site
• Pain managed with medications
• Gradual improvement in symptoms as healing progresses