Shortening of tendon, extensor, hand or finger, each tendon
CPT4 code
Name of the Procedure:
Shortening of Tendon, Extensor, Hand or Finger (Extensor Tendon Shortening)
Summary
Extensor tendon shortening is a surgical procedure in which a tendon in the hand or finger is shortened to restore optimal function and alignment. This helps improve the movement and dexterity of the fingers and hand.
Purpose
The medical condition or problem it addresses:
The procedure addresses issues such as tendon laxity or over-lengthened tendons, which can result from injury, congenital conditions, or certain medical disorders.
The goals or expected outcomes of the procedure:
The primary goal is to restore normal tension to the extensor tendons, improving hand or finger functionality and reducing discomfort.
Indications
Specific symptoms or conditions that warrant the procedure:
- Tendon laxity or injury
- Congenital tendon over-length
- Malalignment of tendons leading to impaired functionality
- Persistent pain or weakness in the hand or fingers
Patient criteria or factors that make the procedure appropriate:
- Patients with chronic tendon injuries not responding to conservative treatments
- Individuals with congenital hand function abnormalities
- Patients with specific deformities affecting hand mechanics
Preparation
Pre-procedure instructions for the patient:
- Fasting for 6-8 hours if general anesthesia is used
- Adjustments or cessation of certain medications, as advised by the surgeon
- Arranging for transportation and post-surgery care
Any diagnostic tests or assessments required beforehand:
- X-rays or MRI to assess the extent of tendon damage
- Blood tests to ensure suitability for surgery
- Pre-operative consultation with the surgical team
Procedure Description
Detailed step-by-step explanation:
- The patient is administered local or general anesthesia.
- An incision is made over the affected tendon.
- The tendon is identified and isolated.
- A portion of the tendon is carefully removed or shortened.
- The tendon ends are realigned and sutured together.
- The incision is closed, and a sterile dressing is applied.
Tools, equipment, or technology:
- Surgical scalpel and scissors
- Sutures and stitching equipment
- Sterile drapes and gloves
Anesthesia or sedation details:
- Either local anesthesia with sedation or general anesthesia, depending on patient and surgeon preferences.
Duration
Typically, the procedure takes about 1-2 hours.
Setting
The procedure is performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurses
- Anesthesiologist/Anesthetist
- Surgical technologist
Risks and Complications
Common risks:
- Infection at the surgical site
- Bleeding or hematoma formation
- Pain and swelling
Rare risks:
- Tendon rupture or failure
- Nerve damage
- Persistent stiffness or loss of function
Possible complications and their management:
- Infection may be treated with antibiotics.
- Surgical site issues may require further intervention.
Benefits
Expected benefits:
- Improved tendon function and hand/finger dexterity.
- Reduced pain and increased strength. ##### How soon they might be realized:
- Benefits can usually be noticed within weeks to months following the procedure, post-rehabilitation.
Recovery
Post-procedure care and instructions:
- Keeping the surgical area clean and dry.
- Follow-up appointments for suture removal and progress checks.
Expected recovery time and any restrictions:
- Recovery time typically spans 4-6 weeks.
- Restrictions include limited hand use and avoiding heavy lifting.
Alternatives
Other treatment options available:
- Physical therapy and rehabilitation
- Non-surgical treatments
- Tendon transfer or grafting
Pros and cons of alternatives compared to the described procedure:
- Non-surgical treatments are less invasive but may be less effective.
- Tendon transfer or grafting are more complex and may involve longer recovery.
Patient Experience
What the patient might feel or experience during and after the procedure:
- Some discomfort and swelling post-surgery.
- Pain is managed with prescribed medications. ##### Pain management and comfort measures:
- Use of pain relief medications
- Cold compresses for swelling
- Gradual return to normal activities as guided by the surgeon or therapist.