28160 Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each

Name of the Procedure:

Hemiphalangectomy or Interphalangeal Joint Excision, Toe, Proximal End of Phalanx, Each

Summary

This surgical procedure involves the removal of part of a bone (the phalanx) in the toe, specifically at the proximal end, to alleviate discomfort or correct deformities.

Purpose

The procedure addresses conditions like severe deformities, arthritis, or persistent pain in the toe joint that doesn't respond to other treatments. The goal is to relieve pain, improve toe alignment, and restore foot function.

Indications

• Persistent pain in the interphalangeal joint of the toe
• Deformities such as bunions or hammer toes
• Arthritis localized to the toe joint
• Non-responsive to conservative treatments such as orthotics or medications

Preparation

• Patients may need to fast for a few hours before the procedure.
• Adjustments to current medications, particularly blood thinners.
• Pre-operative assessment including blood tests, imaging studies like X-rays or MRIs.

Procedure Description

1. The patient is positioned, and an anesthetic is administered (local or general based on the case).
2. An incision is made over the affected toe.
3. The surgeon removes the proximal end of the phalanx.
4. The surgical site is cleaned and closed with sutures.
5. A dressing or bandage is applied to protect the surgical area.

Tools and equipment used may include surgical scalpels, retractors, and suturing materials.

Duration

The procedure typically takes about 30-60 minutes.

Setting

It is performed in a hospital or outpatient surgical center.

Personnel

• Orthopedic surgeon or podiatrist
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Nerve damage
• Scarring
• Poor wound healing
• Recurrence of the condition

Benefits

• Relief from pain
• Improved toe function and alignment
• Enhanced ability to walk and perform daily activities

Benefits are often realized within a few weeks post-surgery.

Recovery

• Rest and elevate the foot for the initial few days
• Pain management with medications
• Limited weight-bearing with crutches or a walker initially
• Follow-up visits for suture removal and progress assessment
• Full recovery typically within 4-6 weeks, depending on the patient's compliance and overall health

Alternatives

• Conservative treatments (orthotics, pain medication, physical therapy)
• Other surgical options like full phalangectomy or joint fusion Each alternative comes with its own sets of pros and cons regarding invasiveness, recovery time, and effectiveness.

Patient Experience

• Patients may feel discomfort and swelling post-procedure.
• Pain is usually managed with prescribed medications.
• Gradual improvement in mobility and reduced pain in the following weeks. Comfort measures like ice packs and elevation aid in reducing swelling and discomfort.