Name of the Procedure:

Radical Resection of Tumor, Proximal or Middle Phalanx of Finger

Summary

The radical resection of a tumor in the proximal or middle phalanx of a finger involves surgically removing the tumor along with some surrounding healthy tissue. This is done to ensure complete removal and prevent recurrence.

Purpose

This procedure addresses the presence of malignant or benign tumors in the bony segments of the finger. The primary goal is to eradicate the tumor, alleviate pain, and preserve as much hand function as possible.

Indications

• Presence of a confirmed malignant tumor (e.g., bone cancer) in the proximal or middle phalanx.
• Large benign tumors causing pain, deformity, or functional impairment.
• Recurrent tumors that have not responded to less invasive treatments.

Preparation

• Fasting for 8-12 hours before surgery.
• Avoiding certain medications such as blood thinners, as advised by the doctor.
• Pre-operative imaging studies like X-rays, MRI, or CT scans to assess the tumor size and location.
• Blood tests and other routine pre-surgical evaluations.

Procedure Description

1. The patient is administered anesthesia (general or regional).
2. The surgical area is sterilized.
3. An incision is made over the affected phalanx.
4. The surgeon carefully excises the tumor along with a margin of healthy tissue.
5. Reconstruction of the remaining bone and soft tissue using grafts or prosthetics if necessary.
6. The incision is closed with sutures, and a sterile dressing is applied.
7. A splint or cast may be used to immobilize the finger.

Duration

The procedure typically takes 1-3 hours, depending on the complexity and extent of the tumor.

Setting

This procedure is usually performed in a hospital operating room.

Personnel

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

Risks and Complications

• Infection
• Bleeding
• Damage to surrounding nerves or blood vessels
• Incomplete removal leading to tumor recurrence
• Stiffness or reduced function of the finger
• Need for additional surgery

Benefits

• Complete removal of the tumor.
• Relief from pain and other tumor-related symptoms.
• Potentially preserved hand function and improved quality of life.
• Reduced risk of cancer spread in malignant cases.

Recovery

• Monitoring in the hospital for 24-48 hours.
• Pain management with prescribed medications.
• Keeping the finger elevated and immobilized initially.
• Follow-up appointments for wound care, removal of sutures, and rehabilitation.
• Physical therapy may be required to restore finger function.
• Full recovery can take several weeks to months.

Alternatives

• Non-surgical options like radiation or chemotherapy (for certain cancerous tumors).
• Less invasive surgical procedures (e.g., curettage) for benign tumors.
• Pros: Less invasive alternatives may have shorter recovery and lower immediate risks.
• Cons: They may not be as effective in completely removing the tumor.

Patient Experience

Patients will experience anesthesia during the procedure, ensuring they feel no pain. Post-surgery, there may be pain and swelling managed by pain relief medications. Recovery involves rest, limited use of the hand, and possible physical therapy to regain motion and strength. Comfort measures include elevation, cold packs, and prescribed medications.