Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Metacarpal

Summary

The excision or curettage of a bone cyst or benign tumor of the metacarpal is a surgical procedure that involves removing abnormal growths or lesions from the bone in the hand. This procedure aims to prevent pain, fractures, and potential functional impairment associated with these growths.

Purpose

This procedure addresses bone cysts or benign tumors in the metacarpal bones. The goal is to alleviate pain, restore function, and prevent complications such as fractures or deformities in the hand.

Indications

• Persistent pain in the hand
• Detectable lump or abnormal growth in the metacarpal area
• Radiographic findings of a bone cyst or benign tumor
• Functional impairment or risk of fracture due to the abnormal growth

Preparation

• Fasting may be required if general anesthesia is used.
• Preoperative blood tests and imaging studies such as X-rays or MRIs.
• Medication review and adjustments, particularly for blood thinners.
• Instructions will be given regarding what to do before the procedure, including ceasing certain medications.

Procedure Description

1. The patient is brought to the operating room and positioned for hand surgery.
2. Anesthesia is administered. This can be local, regional, or general anesthesia depending on the case.
3. An incision is made over the affected metacarpal bone.
4. The surgeon uses specialized instruments to carefully excise or curettage (scrape out) the bone cyst or benign tumor.
5. The bone may be stabilized with medical hardware if necessary.
6. The incision is closed with sutures, and the area may be bandaged or immobilized.

Duration

Typically, the procedure takes between 1 to 2 hours.

Setting

The procedure is usually performed in an outpatient surgical center or a hospital operating room.

Personnel

• Orthopedic or hand surgeon
• Anesthesia team (anesthesiologist and/or nurse anesthetist)
• Surgical nurses and technologists

Risks and Complications

• Infection at the surgical site
• Bleeding or hematoma formation
• Damage to surrounding tissues, including nerves and blood vessels
• Recurrence of the bone cyst or tumor
• Anesthesia-related risks such as allergic reactions or complications

Benefits

• Relief from pain caused by the bone cyst or tumor.
• Restoration of normal hand function.
• Prevention of potential fractures or deformities.
• Most benefits are realized within a few weeks post-surgery.

Recovery

• Instructions on keeping the hand elevated and dry.
• Pain management with prescribed medications.
• Physical therapy may be recommended to restore movement and strength.
• Follow-up appointments for suture removal and to check healing.
• Most patients can resume normal activities within 4 to 6 weeks, though full recovery may take longer.

Alternatives

• Observation and regular monitoring for small, asymptomatic cysts or tumors.
• Non-surgical management, such as aspiration or injection of the cyst.
• Compared to surgery, these alternatives might have a lower immediate risk but may not provide lasting relief.

Patient Experience

• During the procedure, if under general anesthesia, the patient will be unconscious and feel no pain.
• Post-procedure, there may be discomfort or pain managed with medications.
• Swelling and bruising around the surgical site are common.
• Instructions will be given to promote healing and ensure comfort during recovery, including using ice packs and elevating the hand.