28175 Radical resection of tumor; phalanx of toe

Name of the Procedure:

Radical Resection of Tumor; Phalanx of Toe

• Also known as: Tumor Excision from Toe Phalanx, Toe Bone Tumor Removal

Summary

Radical resection of a tumor in the phalanx of the toe is a surgical procedure to remove a cancerous or benign tumor from one of the small bones in the toe. This intervention aims to eliminate the tumor and prevent its spread or recurrence while preserving as much toe function as possible.

Purpose

• Medical condition: Removal of benign or malignant tumors from the toe bones (phalanges).
• Goals: The primary goal is complete tumor removal to prevent metastasis (for cancerous tumors) or recurrence, alleviate pain, and restore normal toe function.

Indications

• Symptoms: Persistent pain, visible swelling, or deformity of the toe.
• Conditions: Diagnosis of a benign or malignant bone tumor in the phalanx.
• Patient Criteria: Suitable candidates typically include those with localized tumors that have not responded to other treatments or where other treatments are not viable.

Preparation

• Pre-procedure Instructions: Fasting for at least 8 hours before surgery. Adjustments to current medications, including blood thinners.
• Diagnostic Tests: Imaging studies such as X-rays, MRI, or CT scans to determine the tumor's size and exact location; possible biopsy to confirm diagnosis.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the affected toe.
3. Tumor Exposure: The phalanx is exposed, and surrounding tissues are carefully retracted.
4. Tumor Removal: The surgeon excises the tumor with a margin of healthy tissue to ensure complete removal.
5. Reconstruction: Any bone defects are addressed, possibly using bone grafts or internal fixation devices.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.
   • Tools & Equipment: Surgical scalpels, retractors, bone cutters, possibly graft materials.
   • Anesthesia Details: Administered by an anesthesiologist to ensure patient comfort.

Duration

Approximately 1-3 hours, depending on tumor size and complexity.

Setting

Generally performed in a hospital operating room or a specialized surgical center.

Personnel

• Primary Surgeon (Orthopedic Surgeon or Surgical Oncologist)
• Surgical Assistants
• Anesthesiologist
• Scrub Nurses and Circulating Nurses

Risks and Complications

• Common Risks: Infection, bleeding, pain, swelling.
• Rare Risks: Nerve or blood vessel damage, incomplete tumor removal, recurrence of the tumor, complications related to anesthesia.
• Management: Antibiotics for infection, pain medications, physical therapy for functional recovery.

Benefits

• Tumor eradication, reduction of pain, correction of toe deformity, and prevention of further complications.
• Benefits are typically realized within weeks to months post-surgery, depending on recovery.

Recovery

• Post-procedure Care: Keeping the foot elevated, wound care, pain management, antibiotics if prescribed.
• Recovery Time: Generally 6-12 weeks for complete healing.
• Restrictions: Limited weight-bearing on the affected foot, avoidance of strenuous activities, wearing protective footgear.
• Follow-up: Regular visits to monitor healing and tumor recurrence.

Alternatives

• Other Treatments: Radiation therapy, chemotherapy, cryotherapy, less invasive surgical options if applicable.
• Pros and Cons: Non-surgical options may be less invasive but may not provide complete tumor removal. Radical resection provides definitive treatment but involves inherent surgical risks.

Patient Experience

• During Procedure: The patient will be under anesthesia and will not experience pain or discomfort.
• After Procedure: Pain and swelling are common; managed with medications. Patients can expect a period of limited mobility and will be provided with instructions to ensure comfort and proper healing.