Name of the Procedure:

Excision or Curettage of Bone Cyst or Benign Tumor of Proximal, Middle, or Distal Phalanx of Finger; With Autograft (Includes Obtaining Graft)

Summary

This procedure involves the surgical removal (excision) or scraping (curettage) of a bone cyst or benign tumor in the finger. An autograft, which is a graft taken from another part of the patient's body, is used to fill the void left by the removed cyst or tumor.

Purpose

This procedure addresses bone cysts or benign tumors located in the phalanges (bones) of the fingers. The goal is to remove the abnormal growth, relieve symptoms, and restore hand function by filling the resulting cavity with healthy bone tissue.

Indications

• Persistence of a bone cyst or benign tumor in the finger
• Pain or discomfort in the affected finger
• Decreased hand function or finger movement
• Risk of fracture or structural instability in the affected bone

Preparation

• Fasting: May be required if general anesthesia is used
• Medication adjustments: Certain medications may need to be paused
• Preoperative assessments: X-rays, MRI, or CT scans to evaluate the cyst or tumor's size and location

Procedure Description

1. Anesthesia: Local or general anesthesia is administered to ensure patient comfort.
2. Incision: A small incision is made over the affected area of the finger.
3. Removal: The cyst or tumor is carefully excised or scraped out.
4. Graft Harvesting: Bone graft tissue is collected from another part of the patient's body, such as the pelvis.
5. Graft Placement: The autograft is placed into the cavity left by the cyst or tumor.
6. Closure: The incision is closed with sutures or surgical glue, and a dressing is applied.

Duration

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

Setting

This surgery is usually performed in a hospital or surgical center.

Personnel

• Orthopedic surgeon or hand surgeon
• Anesthesiologist
• Surgical nurses and/or technicians

Risks and Complications

• Infection
• Bleeding
• Graft rejection or failure
• Nerve or tissue damage
• Recurrence of the cyst or tumor

Benefits

• Relief from pain and discomfort
• Improved finger and hand function
• Reduced risk of complications like fractures

Recovery

• Post-operative care includes pain management, wound care, and possibly antibiotics.
• Patients may need to wear a splint or cast.
• Recovery time can range from several weeks to a few months.
• Follow-up appointments are necessary to monitor healing.

Alternatives

• Observation if the cyst or tumor is small and asymptomatic
• Needle aspiration or injection treatments
• Other surgical options without the use of an autograft

Patient Experience

• During the procedure: Patients under general anesthesia will be asleep and feel nothing, while those under local anesthesia may feel pressure but no pain.
• After the procedure: Pain and swelling are common, managed with medications. Patients should expect a gradual return to normal hand function with physical therapy if needed.