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Tenolysis, extensor, foot; single tendon

CPT4 code

Name of the Procedure:

Tenolysis, extensor, foot; single tendon

Summary

Tenolysis of the extensor tendon in the foot is a surgical procedure aimed at freeing a tendon from surrounding adhesions or scar tissue. This allows for improved movement and function of the tendon in the foot.

Purpose

This procedure addresses the issue of a tendon in the foot being restricted by adhesions, which can occur after an injury or surgery. The goal of tenolysis is to restore normal tendon movement and function, reducing pain and improving mobility.

Indications

  • Limited range of motion in the foot due to tendon adhesions
  • Pain while moving the foot or toes
  • Previous surgeries or injuries leading to scar tissue around the tendon
  • Failure of non-surgical treatments such as physical therapy to alleviate symptoms

Preparation

  • Patients may be instructed to fast for several hours before the procedure.
  • Medication adjustments, particularly blood thinners, may be necessary.
  • Preoperative assessments may include imaging studies like X-rays or MRIs to evaluate the extent of adhesions.

Procedure Description

  1. The patient is typically given regional anesthesia to numb the area, and sometimes sedation is used for comfort.
  2. A small incision is made over the affected tendon of the foot.
  3. The surgeon carefully separates the tendon from the surrounding adhesions using specialized instruments.
  4. The incision is then closed with sutures, and a sterile dressing is applied.

Duration

The procedure usually takes about 30 minutes to one hour, depending on the extent of adhesions.

Setting

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

Personnel

  • Orthopedic surgeon or a specialist in foot and ankle surgery
  • Surgical nurse
  • Anesthesiologist or nurse anesthetist

Risks and Complications

  • Infection
  • Bleeding
  • Nerve damage
  • Recurrence of adhesions
  • Incomplete release of the tendon

Benefits

  • Improved range of motion in the foot
  • Decreased pain
  • Enhanced ability to perform daily activities and exercise
  • Benefits are usually realized within a few weeks post-surgery

Recovery

  • Patients are often advised to keep weight off the foot for a few days.
  • Follow-up appointments are needed to monitor healing.
  • Physical therapy may be recommended to restore strength and flexibility.
  • Most patients can return to normal activities within 4-6 weeks, but this can vary.

Alternatives

  • Non-surgical treatments such as physical therapy, anti-inflammatory medications, or corticosteroid injections can be tried first.
  • The effectiveness of these alternatives may vary, and they may not provide the same long-term relief as surgery.

Patient Experience

  • Patients may feel discomfort or pain at the incision site immediately after surgery, which can be managed with prescribed pain medications.
  • Swelling and bruising are common but typically resolve within a few days to weeks.
  • Physical therapy will help in regaining motion and strength, and patients are encouraged to follow their therapist's recommendations closely.

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