Ostectomy, excision of tarsal coalition
CPT4 code
Name of the Procedure:
Ostectomy, Excision of Tarsal Coalition
Summary
An ostectomy for the excision of tarsal coalition is a surgical procedure that removes abnormal bone or tissue connections between the tarsal bones in the foot. This procedure aims to restore normal movement and alleviate pain.
Purpose
The primary purpose of this procedure is to address tarsal coalition, a condition where two or more of the tarsal bones in the foot are abnormally connected. This connection can limit joint mobility and cause pain. The goal of the surgery is to restore normal movement, relieve pain, and improve foot function.
Indications
- Persistent foot pain or stiffness, especially during activity
- Restricted foot movement
- Frequent ankle sprains or instability
- Ineffectiveness of conservative treatments such as physical therapy or orthotics Patients who typically benefit from this procedure are those experiencing significant symptoms that interfere with daily activities.
Preparation
- Fasting for at least 8 hours before surgery if general anesthesia is used
- Adjustment or cessation of medications, as advised by the doctor
- Pre-operative imaging tests, such as X-rays or CT scans, to plan the surgery
- Complete medical evaluation and lab tests to ensure fitness for surgery
Procedure Description
- Administration of anesthesia (general or regional)
- Making an incision over the affected area of the foot
- Identification and careful removal of the tarsal coalition using specialized surgical instruments
- Inspecting the area to ensure complete excision of the abnormal tissue
- Closing the incision with sutures
- Applying a sterile dressing to the wound site
Duration
The procedure typically takes around 1 to 2 hours, depending on the complexity of the coalition.
Setting
The surgery is performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection at the surgical site
- Nerve damage resulting in numbness or tingling
- Recurrence of the coalition
- Post-operative pain and swelling
- Delayed wound healing
- Blood clots
Benefits
- Pain relief
- Improved foot function and mobility
- Lower risk of future foot or ankle problems Benefits are generally realized within a few weeks to months after surgery.
Recovery
- Keeping weight off the foot for several weeks, as directed by the surgeon
- Use of crutches or a walking boot during the initial healing phase
- Gradual return to normal activities with physical therapy
- Follow-up appointments to monitor healing and progress
- Full recovery typically takes several months
Alternatives
- Non-surgical treatments such as orthotics, physical therapy, or anti-inflammatory medications
- Arthrodesis (surgical fusion of the affected bones) in severe cases
- Pros and cons: Non-surgical treatments are less invasive but may not be effective long-term, while arthrodesis provides permanent relief but limits movement in the affected joint.
Patient Experience
The patient will be under anesthesia during the procedure, hence they should not feel pain. Post-procedure, they may experience pain, swelling, and discomfort, which can be managed with prescribed pain medications and ice therapy. The use of crutches or a boot may be necessary to keep weight off the foot. Physical therapy will aid in recovery and help regain strength and mobility.
Pain management and comfort measures will be provided throughout the recovery process to ensure the patient’s well-being.