Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)
CPT4 code
Name of the Procedure:
Reconstruction of Collateral Ligament of the Metacarpophalangeal Joint, Single; with Local Tissue (e.g., Adductor Advancement)
Summary
This is a surgical procedure aimed at repairing a damaged collateral ligament in the metacarpophalangeal (MCP) joint of a finger, using tissue from a nearby area to enhance stability and function.
Purpose
The procedure addresses issues such as ligament tears or instability in the MCP joint. It aims to restore proper joint function, alleviate pain, and prevent further joint deterioration.
Indications
- Joint instability or dislocation in the MCP joint.
- Severe pain in the finger joint that does not respond to conservative treatments.
- Chronic ligament tears that impair daily activities.
Preparation
- Pre-operative fasting might be required.
- Adjustment or temporary cessation of certain medications (e.g., blood thinners).
- Pre-surgical imaging tests such as X-rays or MRI scans to assess the extent of the damage.
Procedure Description
- Anesthesia: The patient is given local or regional anesthesia to numb the area.
- Incision: A surgical incision is made near the MCP joint.
- Tissue Harvesting: Tissue (e.g., part of the adductor muscle) is harvested from a nearby area.
- Ligament Repair: The harvested tissue is used to reconstruct the damaged ligament.
- Closure: The incision is closed with sutures, and a bandage is applied.
Duration
The procedure typically takes about 1-2 hours.
Setting
The surgery is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Anesthesiologist or nurse anesthetist
- Surgical nurses and technicians
Risks and Complications
- Infection at the surgical site
- Nerve damage leading to numbness or tingling
- Incomplete recovery of joint function
- Blood clots or excessive bleeding
Benefits
- Improved joint stability and function
- Reduction in pain
- Enhanced ability to perform daily activities
- Prevention of future joint damage
Recovery
- Wearing a splint or cast for several weeks to immobilize the joint
- Instructions on wound care and activity restrictions
- Physical therapy may be required to restore full function
- Follow-up appointments to monitor healing
Alternatives
- Non-surgical approaches such as physical therapy, medication, and splinting
- Other surgical options like tendon transfers or synthetic ligament implants
- Each alternative has its own risks and benefits, generally compared based on severity and patient condition.
Patient Experience
- The patient may experience some discomfort and swelling post-surgery, which can be managed with pain medications.
- Sensations of stiffness and temporary loss of movement, improving as recovery progresses.
- Physical therapy plays a critical role in achieving optimal recovery.
This markdown document provides a comprehensive overview of the procedure for reconstructing the collateral ligament at the metacarpophalangeal joint with local tissue. The information helps patients understand what to expect and prepares them adequately for surgery and recovery.