25265 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft (includes obtaining graft), each tendon or muscle

Name of the Procedure:

Repair, Tendon or Muscle, Flexor, Forearm and/or Wrist; Secondary, with Free Graft (includes obtaining graft), Each Tendon or Muscle

Summary

This procedure involves repairing damaged flexor tendons or muscles in the forearm or wrist using a free graft. The graft is typically taken from the patient's own body to replace or reinforce the injured tendon or muscle.

Purpose

The procedure aims to restore function and mobility to the hand and wrist, which may have been impaired due to injury, chronic conditions, or previous surgical interventions. It allows the patient to regain strength, flexibility, and the ability to perform daily tasks.

Indications

• Persistent pain or dysfunction in the forearm or wrist due to tendon or muscle damage.
• Previous unsuccessful tendon repair surgery.
• Conditions such as tendon lacerations, ruptures, or degeneration.
• Loss of hand function affecting daily activities.

Preparation

• Patients may be instructed to fast for 6-8 hours before the procedure.
• Adjustment of medications, especially blood thinners, may be necessary.
• Diagnostic tests such as MRI or ultrasound imaging may be required to assess the extent of the tendon or muscle damage.

Procedure Description

1. Anesthesia: The patient is given general anesthesia or a regional block to numb the area.
2. Incision: An incision is made over the affected area of the forearm or wrist.
3. Graft Harvesting: A suitable tendon graft is harvested from another part of the body, usually the leg.
4. Repair: The damaged tendon or muscle is repaired using the graft, which is sutured in place.
5. Testing: The repair is tested for proper tension and movement.
6. Closure: The incision is closed with sutures, and a sterile dressing is applied.

Duration

The procedure typically takes 2 to 3 hours, depending on the complexity and extent of the repair required.

Setting

The procedure is performed in a hospital or a specialized surgical center.

Personnel

• Orthopedic or hand surgeon.
• Surgical nurses.
• Anesthesiologist.

Risks and Complications

• Infection
• Bleeding or hematoma
• Graft rejection or failure
• Nerve damage leading to numbness or weakness
• Stiffness or reduced range of motion
• Scarring

Benefits

• Restoration of hand and wrist function.
• Reduction in pain and discomfort.
• Improved strength and flexibility.
• Ability to perform daily tasks and activities.

Recovery

• Post-procedure immobilization with a brace or splint.
• Pain management with prescribed medications.
• Physical therapy to regain strength and flexibility.
• Follow-up appointments to monitor healing.
• Recovery time varies but often takes several months.

Alternatives

• Non-surgical options such as physical therapy, splinting, or injections.
• Other surgical techniques like primary repair or tendon transfer.
• The choice between alternatives depends on the specific condition and patient factors.

Patient Experience

During the procedure, the patient should feel no pain due to anesthesia. Afterward, there might be discomfort and swelling, managed by medications. Physical therapy will be an integral part of recovery to help regain function and strength.

Ensuring proper rest and adherence to post-operative instructions will aid in a smoother recovery.