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Repair, extensor tendon, leg; primary, without graft, each tendon

CPT4 code

Name of the Procedure:

Repair, extensor tendon, leg; primary, without graft, each tendon

Summary

This procedure involves surgically mending a damaged extensor tendon in the leg. Extensor tendons are crucial for straightening the foot and enabling activities like walking and running. The repair focuses on restoring the tendon's function without using grafts to reinforce the repair.

Purpose

The procedure addresses issues such as torn or ruptured extensor tendons in the leg. The goal is to restore normal tendon function, improve mobility, and alleviate pain, allowing the patient to resume usual activities.

Indications

  • Torn or ruptured extensor tendon(s) in the leg
  • Inability to extend or straighten the foot
  • Persistent pain and swelling in the leg
  • Difficulty walking or performing daily activities due to tendon issues

Preparation

  • Pre-procedure instructions may include fasting for a certain period.
  • Medication adjustments, such as stopping blood thinners.
  • Diagnostic tests, such as MRI or ultrasound, to assess the extent of tendon damage.
  • Pre-operative physical evaluation and medical history review.

Procedure Description

  1. Anesthesia: The procedure begins with administration of local or general anesthesia.
  2. Incision: A small incision is made near the damaged tendon.
  3. Tendon Access: The surgeon carefully exposes the extensor tendon.
  4. Repair: Using sutures, the torn ends of the tendon are meticulously sewn together.
  5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Specialized surgical instruments and sutures are used during the repair process.

Duration

The procedure typically takes 1 to 2 hours, depending on the extent of the damage and the number of tendons being repaired.

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

  • Orthopedic surgeon
  • Anesthesiologist
  • Surgical nurses
  • Surgical technologists

Risks and Complications

  • Infection at the incision site
  • Tendon re-rupture or incomplete healing
  • Scarring or adhesions affecting mobility
  • Nerve or blood vessel damage
  • Complications related to anesthesia

Benefits

  • Restored function and strength of the extensor tendon
  • Improved mobility and ability to perform daily activities
  • Pain relief and reduced swelling

Recovery

  • Post-procedure care may include immobilization of the leg with a splint or cast.
  • Instructions on wound care and keeping the incision clean.
  • Physical therapy to gradually regain strength and range of motion.
  • Complete recovery can take several weeks to months, with restrictions on weight-bearing and high-impact activities initially.

Alternatives

  • Non-surgical treatments such as physical therapy and bracing, though these may not fully restore tendon function.
  • Tendon transfer surgery, using a graft from another tendon if primary repair is insufficient.
  • Each alternative has its own set of pros and cons compared to primary repair without graft.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-operatively, there may be some discomfort and swelling, which can be managed with pain medication. Physical therapy will be integral to the healing process, and patients will gradually regain strength and mobility.

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