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PREOPERATIVE DIAGNOSIS: Painful 1st MCJ exostosis with oe!l"in# #an#lion $"st on

%%%foot&

POSTOPERATIVE DIAGNOSIS: Painful 1st MCJ exostosis with oe!l"in# #an#lion $"st on%%%foot&

PROCED'RE: Exoste$to(" of the )o!sal %%% ta!so(etata!sal *oint+ %%%foot&

S'RGEON,S-: %%%

ASSISTANT,S-: %%%

ANEST.ESIA: /o$al anestheti$ with (onito!e) anesthesia $a!e&

PAT.O/OG0: Ex$ise) %%% $"st sent fo! se$i(en&

MICRO2IO/OG0: None&

.EMOSTASIS: Pneu(ati$ an3le tou!ni4uet&

ESTIMATED 2/OOD /OSS: Mini(al&

MATERIA/S: None&

INJECTA2/ES: None&

DRESSINGS: Stan)a!)&

COMP/ICATIONS: None&

PROCED'RE IN DETAI/: The atient !e$eie) 1 #!a( of An$ef !eoe!atiel" an) un)e! (il)

se)ation was 5!ou#ht into the oe!atin# !oo( an) la$e) suine on the ta5le& A su!#i$al ti(e6outwas then ta3en )u!in# whi$h the atient+ the su!#i$al site an) the !o$e)u!e we!e e!ifie)& A

neu(ati$ an3le tou!ni4uet was then la$e) oe! a))e) 7e5!il a!oun) the %%%an3le& 8ollowin#

int!aenous se)ation+ lo$al anestheti$ was infilt!ate) a5out the atient9s fi!st (etata!sal usin#

%%%$$ of a 1:1 (ixtu!e of ; li)o$aine lain an) e) toexsan#uinate the %%%lowe! ext!e(it" an) the tou!ni4uet was then inflate)&

Attention was )i!e$te) to the )o!sal ase$t of the %%% (etata!so6$uneifo!( *oint+ whe!e a

lon#itu)inal s3in in$ision was (a)e& The s3in in$ision was then )eeene)+ %%%at whi$h oint we

note) a #an#lion li3e $"st oe!l"in# the exostosis& The $"st?5u!sa was $a!efull" ex$ise) an) sent

to atholo#"& Disse$tion was $ontinue) )own to the $asule aoi)in# an" neu!oas$ula!

st!u$tu!es& On$e the $asule was exose)+ a lon#itu)inal $asuloto(" was e!fo!(e) an) the$asule was !efle$te) (e)iall" an) late!all"+ exosin# the exostosis& A la!#e )o!sal exostosis was

note) oe! the %%% ta!so6(etata!sal *oint+ whi$h was !e(oe) usin# an osteoto(e& The!e su!fa$e

was fashione) usin# the a !on#eu! an) !as& The *oint su!fa$es we!e exa(ine) an) foun) to hae

%%% a!ti$ula! $a!tila#e&

The woun) was i!!i#ate) with $oious a(ounts of no!(al saline& The $asule was

!ea!oxi(ate) usin# @6< Pol"so!5 sutu!e& The s3in was then $lose) usin# a !unnin#

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su5$uti$ula! a5so!5a5le sutu!e an) Ste!i6St!is& The in$ision was then )!esse) with 2eta)ine6

soa3e) A)ati$ $oe!e) with #au>e+ fluffs+ Blin#+ an) Co5an& The neu(ati$ an3le tou!ni4uet

was then )eflate) an) !o(t h"e!e(i$ !esonse was note) to all )i#its of the %%%foot&

The atient tole!ate) the !o$e)u!e an) anesthesia well& %%% was t!ansfe!!e) to the Re$oe!"

Roo( with ital si#ns ta5le an) neu!oas$ula! status inta$t to the 5ilate!al lowe! ext!e(it"&

8ollowin# a e!io) of ostoe!atie (onito!in#+ the atient will 5e )is$ha!#e) ho(e with

inst!u$tions to eleate an) i$e when at !est& A(5ulation in su!#i$al shoe& Bee )!essin# $lean+

)!"+ an) inta$t until follow u aoint(ent& Retu!n to $lini$ fo! ostoe!atie follow u in two

wee3s& Call $lini$ if !o5le(s a!ise&