26850 Arthrodesis, metacarpophalangeal joint, with or without internal fixation

Name of the Procedure:

Arthrodesis, Metacarpophalangeal Joint (MCP Joint Fusion)

Summary

Arthrodesis of the metacarpophalangeal (MCP) joint is a surgical procedure that fuses the bones of a joint together, eliminating movement to provide stability and relief from pain.

Purpose

This procedure addresses severe joint pain, instability, or deformity in the MCP joint often due to arthritis, trauma, or other degenerative conditions. The goal is to alleviate pain, correct deformities, and improve hand function by providing a stable joint.

Indications

• Severe arthritis (e.g., rheumatoid arthritis)
• Traumatic joint injury
• Instability or significant deformity of the MCP joint
• Failed previous surgical treatments
• Chronic pain unresponsive to conservative treatments

Preparation

• Pre-operative fasting (typically 8-12 hours prior)
• Medication adjustments (e.g., stopping blood thinners)
• Preoperative diagnostic tests such as X-rays or MRI
• Blood tests and general health assessment

Procedure Description

1. Anesthesia: The patient receives local, regional, or general anesthesia.
2. Incision: An incision is made over the MCP joint.
3. Preparation of Joint Surfaces: The cartilage is removed from the bone ends.
4. Bone Alignment: The bones are positioned to provide the desired alignment.
5. Fixation: The bones are fixed in place using metal plates, screws, or wires.
6. Closure: The incision is closed with sutures, and a bandage or splint is applied to immobilize the joint.

Duration

The procedure typically takes about 1-2 hours.

Setting

The procedure is generally performed in a hospital or surgical center.

Personnel

• Orthopedic Surgeon
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications

• Infection
• Bleeding
• Non-union or failure of bones to fuse
• Hardware irritation or failure
• Nerve damage
• Stiffness or loss of dexterity

Benefits

• Relief from chronic pain
• Improved joint stability
• Corrected deformity
• Enhanced hand function Benefits are often realized within a few weeks to months after surgery.

Recovery

• Follow post-operative instructions carefully, including wound care.
• Immobilization using splints or casts for 4-6 weeks.
• Gradual return to activities under the guidance of a healthcare provider.
• Physical therapy may be recommended.
• Follow-up appointments to monitor healing.

Alternatives

• Medications: Pain relievers or anti-inflammatory drugs.
• Physical Therapy: Hand exercises and joint mobilization.
• Joint Injections: Corticosteroids or hyaluronic acid.
• Other Surgical Options: Joint replacement or joint reconstruction.

Patient Experience

• Preoperative: Anxiety managed with explanations and medication if necessary.
• During Procedure: The patient will not feel pain due to anesthesia.
• Postoperative: Pain managed with prescribed pain relievers.
• Postoperative care includes managing discomfort, adhering to immobilization, and attending follow-up appointments to ensure proper recovery.