64832 Suture of digital nerve, hand or foot; each additional digital nerve (List separately in addition to code for primary procedure)

Name of the Procedure:

Suture of Digital Nerve, Hand or Foot (each additional digital nerve)

Summary

This procedure involves stitching or repairing an additional digital nerve in the hand or foot, typically after an injury. It is performed separately in addition to a primary nerve repair procedure.

Purpose

The procedure addresses nerve damage in fingers or toes, aiming to restore sensation and function. The expected outcome is improved nerve function and decreased sensory deficits.

Indications

• Nerve lacerations or trauma in the fingers or toes.
• Loss of sensation or motor function in the affected digit.
• Patients who have sustained sharp or crush injuries to the hand or foot.

Preparation

• Fasting for at least 6-8 hours before surgery, if general anesthesia is to be used.
• Adjustments in medication may be needed, particularly blood thinners.
• Preoperative imaging or nerve conduction studies might be required.

Procedure Description

1. The patient is positioned to allow easy access to the affected digit.
2. Anesthesia is administered, typically local or regional, but may involve general anesthesia.
3. The surgical area is sterilized.
4. An incision is made to expose the injured digital nerve.
5. The ends of the injured nerve are identified and aligned.
6. Fine sutures are used to carefully stitch the nerve ends together.
7. The incision is closed with sutures and dressed.
8. The procedure for each additional digital nerve is similar.

Duration

Each additional digital nerve repair typically takes 30-60 minutes, depending on the complexity.

Setting

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

Personnel

• Surgeons, specializing in hand or foot surgery.
• Surgical nurses.
• Anesthesiologists or nurse anesthetists.

Risks and Complications

• Infection at the surgical site.
• Nerve regeneration issues or incomplete recovery of nerve function.
• Scar tissue formation.
• Prolonged numbness or tingling.
• Rarely, allergic reactions to anesthesia.

Benefits

• Restoration of sensation and motor function in the affected digit.
• Reduced long-term disability.
• Improved quality of life and ability to perform daily activities.

Recovery

• Keep the affected digit elevated to reduce swelling.
• Wound care as per medical advice, typically including cleaning and dressing changes.
• Physical therapy may be recommended.
• Recovery time can vary from a few weeks to several months.

Alternatives

• Conservative management with splinting and physical therapy.
• Nerve grafting if primary repair is not feasible.
• Each alternative has its own risks and benefits, often depending on the extent of nerve damage.

Patient Experience

• Local or systemic anesthesia minimizes pain during the procedure.
• Some discomfort may be experienced post-operatively, manageable with prescribed pain medications.
• Sensation and function improvement can vary, gradual recovery over weeks to months.