Name of the Procedure:

Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each

Summary

An arthrotomy is a surgical procedure in which an incision is made into a joint, specifically the metacarpophalangeal (MCP) joint, to explore, drain, or remove loose or foreign bodies that may be causing discomfort or impairing joint function.

Purpose

The procedure addresses issues such as joint pain, swelling, infection, or limited movement due to loose bone or cartilage fragments, foreign bodies, or fluid accumulation within the MCP joint. The goal is to alleviate symptoms and restore normal joint function.

Indications

• Persistent joint pain or swelling not responsive to conservative treatments
• Infections in the MCP joint
• Detection of loose bone or cartilage fragments via imaging
• Presence of foreign bodies causing irritation or dysfunction

Preparation

• Patients may be advised to fast for a certain period before the procedure if general anesthesia is used.
• Adjustments to medications, particularly blood thinners, may be necessary.
• Pre-procedure diagnostic tests may include X-rays, MRI, or ultrasound to assess the condition of the joint.

Procedure Description

1. The patient is positioned, and the surgical site is cleaned and sterilized.
2. Anesthesia is administered, which may be local, regional, or general.
3. A surgical incision is made over the MCP joint.
4. The joint is thoroughly explored, and any loose or foreign bodies are identified and removed.
5. If necessary, fluid is drained, and the joint is irrigated to ensure cleanliness.
6. The incision is closed with sutures or staples, and a sterile dressing is applied.

Tools used may include surgical knives, forceps, and irrigation systems.

Duration

The procedure generally takes about 30 minutes to an hour, depending on the complexity and findings during exploration.

Setting

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

Personnel

• Orthopedic or general surgeon
• Surgical nurses
• Anesthesiologist (if applicable)

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Damage to surrounding tissues or nerves
• Joint stiffness or reduced range of motion
• Adverse reactions to anesthesia

Benefits

• Relief from pain and swelling
• Removal of obstructions or foreign bodies that impair joint function
• Improved mobility and joint function
• Prevention of further joint damage

Recovery

• Patients may need to keep the joint immobilized temporarily.
• Pain management may include medications and ice application.
• Physical therapy may be recommended to restore joint function.
• Recovery time varies but typically ranges from a few weeks to a couple of months.
• Follow-up appointments are crucial to monitor healing and progress.

Alternatives

• Conservative treatments such as medications, physical therapy, or steroid injections
• Arthroscopic surgery, which is less invasive but may not be suitable for all cases

Patient Experience

Patients may experience discomfort or mild pain during recovery, which can be managed with prescribed pain medications. Swelling and stiffness are common initially but should improve with time and physical therapy. Most patients report significant relief from previous symptoms once fully recovered.