Reconstruction of polydactylous digit, soft tissue and bone
CPT4 code
Name of the Procedure:
Reconstruction of Polydactylous Digit (Soft Tissue and Bone)
Common names: Polydactyly Reconstruction, Extra Digit Removal Surgery
Summary:
Reconstruction of a polydactylous digit involves the surgical removal or reshaping of an extra finger or toe. This procedure corrects physical deformities and improves both function and appearance of the affected limb.
Purpose:
This procedure addresses polydactyly, a condition where an individual has more than the usual number of fingers or toes. The goal is to enhance the functionality of the hand or foot, alleviate discomfort, and improve cosmetic appearance.
Indications:
- Presence of extra digits (fingers or toes)
- Functional impairment due to extra digits
- Pain or discomfort associated with the extra digits
- Cosmetic concerns
Preparation:
- Fasting for several hours before surgery if general anesthesia is used.
- Adjusting current medications as advised by the doctor.
- Undergoing diagnostic tests such as X-rays or MRI scans to plan the surgery precisely.
Procedure Description:
- Anesthesia: General or local anesthesia is administered.
- Incision: Surgical cuts are made around the extra digit.
- Removal/Reshaping: The extra digit is carefully removed. Bone, soft tissue, and tendons are reshaped or reattached as necessary.
- Closure: The incisions are closed with sutures, and a dressing is applied.
- Casting/Bandaging: The affected limb may be placed in a cast or bandaged for stabilization.
Tools and technology often include surgical scalpels, electrocautery devices, and orthopedic instruments for bone shaping.
Duration:
The procedure typically takes 1 to 3 hours, depending on the complexity.
Setting:
The surgery is usually performed in a hospital or an outpatient surgical center.
Personnel:
- Orthopedic or plastic surgeon
- Surgical nurses
- Anesthesiologist
Risks and Complications:
- Infection
- Bleeding
- Nerve damage
- Scar formation
- Incomplete removal leading to further surgery
Benefits:
- Improved function of the hand or foot
- Reduced pain or discomfort
- Enhanced cosmetic appearance
- Increased ability to perform daily activities
Recovery:
- Post-procedure care includes keeping the incision clean and dry.
- Follow-up appointments to monitor healing.
- Restricted use of the affected limb until fully healed.
- Physical therapy may be needed to restore function.
Alternatives:
- Non-surgical management like splinting (rarely effective for polydactyly)
- Delay of surgery until the child is older (in pediatric cases)
Pros of the described procedure include definitive correction and improved function, while cons of alternatives may include ongoing discomfort and impaired limb usage.
Patient Experience:
- During the procedure, the patient will be under anesthesia and feel no pain.
- Post-operatively, the patient may experience soreness, swelling, and discomfort.
- Pain management will be provided through medications, and comfort measures such as ice packs may be advised.
- Normal activities can typically be resumed after a few weeks, depending on recovery progress.