26370 Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon

Name of the Procedure:

Repair or Advancement of Profundus Tendon, with Intact Superficialis Tendon; Primary, Each Tendon

Summary

This procedure involves repairing or advancing the flexor digitorum profundus (FDP) tendon in the finger while the flexor digitorum superficialis (FDS) tendon remains intact. It is typically performed when the profundus tendon has been injured or damaged, and normal hand function is impaired.

Purpose

This procedure aims to restore full functionality to the affected finger(s) by repairing or repositioning the profundus tendon. The expected outcome is improved finger flexion, strength, and dexterity.

Indications

• Tendon lacerations or tears.
• Loss of flexor function in one or more fingers.
• Inability to bend the fingertip.
• Post-traumatic or degenerative tendon damage.

Preparation

• Fasting for a specified period prior to surgery, usually around 6-8 hours.
• Adjustments of medications as directed by the physician.
• Pre-operative diagnostic tests, such as X-rays or MRI, to assess tendon damage.
• Completing pre-surgical assessments and consultations.

Procedure Description

1. Anesthesia: Regional or general anesthesia is administered.
2. Incision: A small incision is made on the palm or finger.
3. Tendon Repair: The damaged profundus tendon is identified and repaired using sutures or other techniques.
4. Advancement: If necessary, the tendon is advanced to ensure proper length and tension.
5. Closure: The incision is closed with sutures, and a sterile dressing is applied.
6. Immobilization: The finger may be splinted to protect the repair.

Duration

The procedure typically takes about 1-2 hours.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic or hand surgeon.
• Operating room nurses.
• Anesthesiologist.

Risks and Complications

• Infection at the surgical site.
• Tendon re-rupture or failure of the repair.
• Stiffness or reduced range of motion in the finger.
• Adverse reactions to anesthesia.
• Scarring.

Benefits

• Restoration of finger flexion and function.
• Improved hand strength and dexterity.
• Enhanced ability to perform daily activities and tasks.

Recovery

• Follow-up appointments for suture removal and progress evaluation.
• Physical therapy may be recommended to regain strength and flexibility.
• The recovery period may vary but typically ranges from 6 to 12 weeks.
• Patients should avoid heavy lifting and strenuous activities during recovery.

Alternatives

• Non-surgical options such as splinting or corticosteroid injections (may be less effective).
• Other surgical techniques depending on the extent and nature of the injury.
• The pros of surgery include a higher success rate for restoring function; however, the cons include the risks of surgery itself.

Patient Experience

• During the procedure, the patient will be under anesthesia and should not feel pain.
• Post-operative pain and swelling are common, managed with pain medications and anti-inflammatories.
• Patients may experience discomfort and stiffness as they heal and should follow prescribed rehabilitation exercises to optimize recovery.