Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon
CPT4 code
Name of the Procedure:
Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon. (Common Names: Extensor Tendon Repair, Finger Tendon Repair)
Summary
In this procedure, a damaged extensor tendon in a finger is surgically repaired without using a free graft. Extensor tendons run along the back of the hand and fingers and are responsible for straightening the fingers. This repair can be performed as a primary repair soon after an injury or as a secondary repair if initial healing did not occur as expected.
Purpose
The procedure addresses issues such as tears, lacerations, or ruptures in the extensor tendons of a finger. The goal is to restore function, allowing the patient to extend their finger(s) properly and regain normal hand function.
Indications
- Traumatic injuries to the extensor tendon (e.g., cuts or crush injuries).
- Mallet finger deformity (inability to straighten the fingertip).
- Chronic extensor tendon issues not responsive to non-surgical treatments.
Preparation
- Patients may need to fast for several hours before the procedure if general anesthesia is used.
- Pre-operative assessments may include physical exams, imaging studies (e.g., X-rays or ultrasounds), and blood tests.
- Patients should inform the surgical team about any medications, allergies, or medical conditions.
Procedure Description
- The patient is positioned to provide optimal access to the injured finger.
- Local or general anesthesia is administered to ensure comfort.
- An incision is made over the site of the tendon injury.
- The damaged ends of the tendon are located and carefully stitched together using fine sutures.
- The incision is closed with sutures or surgical glue, and a sterile dressing is applied.
- The finger may be immobilized with a splint to protect the repair during healing.
Duration
The procedure typically takes about 45 minutes to 1 hour per tendon.
Setting
This procedure is performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurses
- Anesthesiologist or nurse anesthetist
Risks and Complications
- Infection at the surgical site
- Tendon re-rupture or incomplete healing
- Scar tissue formation, leading to stiffness
- Nerve damage resulting in numbness or tingling
Benefits
- Restoration of normal finger function and ability to extend the finger.
- Improved strength and dexterity in the affected hand.
- Reduced pain associated with tendon tears or malfunctions.
Recovery
- Post-procedure care includes keeping the finger immobilized in a splint for several weeks.
- Patients may need pain medication and antibiotics to prevent infection.
- Follow-up appointments for suture removal and to monitor healing.
- Physical therapy might be recommended to regain strength and flexibility.
- Full recovery typically takes 6-12 weeks, with restrictions on heavy lifting or strenuous activities during this period.
Alternatives
- Non-surgical treatments such as splinting and physical therapy (effective for minor injuries).
- Tendon grafting if the tendon cannot be repaired directly.
- Pros and cons: Surgery usually provides quicker and more complete recovery, but carries surgical risks compared to non-invasive treatments.
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there may be discomfort, swelling, and pain managed with prescribed medications. Patients can expect some restrictions on movement initially, followed by gradual rehabilitation exercises. Pain and discomfort should decrease significantly within a few weeks as healing progresses.