Name of the Procedure:

Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft (includes obtaining graft)

Summary

In layman's terms, this procedure involves removing a cyst or non-cancerous tumor from a bone in the hand (the metacarpal), and using a piece of healthy bone taken from another area of the body to help the metacarpal heal properly.

Purpose

This procedure addresses bone cysts or benign tumors in the metacarpal area of the hand. The goal is to remove the growth to alleviate pain, restore function, and prevent potential fractures or deformities.

Indications

• Persistent pain in the hand.
• Swelling or a noticeable lump on the hand.
• Limited hand function or mobility.
• X-rays or other imaging showing a bone cyst or benign tumor.
• No response to non-surgical treatments like medication or physical therapy.

Preparation

• Fasting may be required a few hours before the procedure.
• Adjustment of current medications as advised by a healthcare provider.
• Preoperative imaging (X-rays, MRI, CT scans) to assess the extent of the cyst or tumor.
• Blood tests to ensure the patient is fit for surgery.

Procedure Description

1. Anesthesia: A general or local anesthesia is administered.
2. Incision: A small incision is made over the affected area of the metacarpal.
3. Removal: The cyst or tumor is carefully excised or scraped out (curettage).
4. Autograft: Bone graft is harvested from another part of the patient’s body, typically the hip.
5. Grafting: The harvested bone is placed in the area where the cyst or tumor was removed.
6. Closure: The incision is closed with sutures.

Duration

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

Setting

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

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Bleeding
• Injury to surrounding tissues or nerves
• Delayed healing or poor integration of the bone graft
• Recurrence of the cyst or tumor
• Pain at the graft donor site
• Scarring

Benefits

• Relief from pain and discomfort.
• Improved hand function and mobility.
• Reduced risk of fractures or deformities in the metacarpal bone.
• Generally, benefits can be realized within a few weeks to months post-surgery.

Recovery

• Pain management with prescribed medications.
• Keeping the hand elevated to reduce swelling.
• Avoiding heavy lifting or strenuous activities for a specified period.
• Follow-up appointments for wound check and removal of sutures.
• Physical therapy may be recommended to restore strength and mobility.

Alternatives

• Watchful waiting with regular monitoring if the cyst or tumor is not causing symptoms.
• Non-surgical treatments like medications or corticosteroid injections.

• Less invasive surgical techniques depending on the specific case.

  Pros and cons should be discussed with the healthcare provider to determine the most suitable option.

Patient Experience

• Initial discomfort and pain manageable with medication.
• Swelling and stiffness are common in the first few days.
• Gradual improvement in pain and function over several weeks.
• Physical therapy can aid in a smoother and faster recovery, improving hand strength and flexibility.