Repair of collateral ligament, metacarpophalangeal or interphalangeal joint
CPT4 code
Name of the Procedure:
Repair of Collateral Ligament, Metacarpophalangeal or Interphalangeal Joint
Common name(s): Collateral Ligament Repair, Finger Joint Ligament Repair
Summary
This procedure involves the surgical repair of the ligaments on either side of the knuckles (metacarpophalangeal joints) or finger joints (interphalangeal joints) to restore stability and function to the finger or thumb.
Purpose
Medical condition or problem it addresses: This procedure addresses injuries or tears to the collateral ligaments of the fingers or thumb, which can result from trauma or chronic conditions.
Goals/Expected outcomes: The aim is to restore stability, functionality, and range of motion to the affected joint, reducing pain and preventing further joint damage.
Indications
- Chronic pain, instability, or loss of function in the finger or thumb joint.
- Acute injury such as a tear or rupture of the collateral ligament.
- Failed conservative treatments such as splinting or physical therapy.
Preparation
- Pre-procedure instructions: Patients may need to fast (not eat or drink) if general anesthesia is used. Medication adjustments might be necessary as advised by the healthcare provider.
- Diagnostic tests/assessments: X-rays, MRI, or ultrasound imaging may be required to assess the extent of the ligament damage and plan the surgery.
Procedure Description
- Anesthesia: Local anesthetic with or without sedation, or general anesthesia, depending on the extent of the surgery and patient preference.
- Incision: An incision is made over the affected joint.
- Repair: The surgeon locates the damaged ligament and repairs it using sutures. In some cases, a graft from another tendon might be used to reinforce the repair.
- Stabilization: The joint may be stabilized temporarily with pins or a splint to ensure proper healing.
Tools/Equipment: Surgical instruments, sutures, pins, or splints.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity of the repair.
Setting
The repair is performed in a hospital, outpatient surgical center, or specialized orthopedic clinic.
Personnel
- Surgeon: Usually an orthopedic or hand surgeon.
- Nursing staff: Assist with the procedure and post-operative care.
- Anesthesiologist: Administers anesthesia and monitors the patient.
Risks and Complications
- Common risks: Infection, bleeding, swelling, and stiffness.
- Rare risks: Nerve damage, failure of the ligament to heal properly, and adverse reactions to anesthesia. Management of complications may include antibiotics for infection or additional surgery if necessary.
Benefits
- Expected benefits: Improved joint stability, reduced pain, and restored function. Benefits are typically realized within several weeks to months following the surgery.
Recovery
- Post-procedure care: Elevation, ice application, and pain management. A splint or cast may be used to immobilize the joint.
- Recovery time: Typically 6 to 12 weeks. Physical therapy may be needed to restore full function.
- Restrictions: Limited use of the hand and fingers until healing is confirmed, followed by gradual return to normal activities.
Alternatives
- Non-surgical treatments: Physical therapy, splinting, and anti-inflammatory medications.
- Pros/Cons: Non-surgical options may provide relief but may not fully restore joint stability or function. Surgery typically offers a more durable solution but involves risks inherent to surgical procedures.
Patient Experience
- During the procedure: Patients may feel pressure but should not feel pain due to anesthesia. Sedatives may help them remain comfortable.
- After the procedure: Some pain and swelling are normal. Pain management includes medications and ice application.
- Comfort measures: Keeping the hand elevated and following the surgeon's aftercare instructions help manage discomfort.
By following the outlined instructions and understanding the procedure, patients can have realistic expectations and a smoother recovery process.