Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured Achilles tendon, with or without graft
CPT4 code
Name of the Procedure:
Anesthesia for procedures on nerves, muscles, tendons, and fascia of the lower leg, ankle, and foot; repair of ruptured Achilles tendon, with or without graft.
Summary
This procedure involves administering anesthesia to numb the lower leg, ankle, and foot to repair a ruptured Achilles tendon, a crucial tendon at the back of the ankle. The repair may involve sewing the tendon back together and, in some cases, using a graft to aid in healing.
Purpose
The procedure addresses a ruptured Achilles tendon, which can cause severe pain and mobility issues if untreated. The goal is to restore function and strength to the affected leg, allowing the patient to return to normal activities with reduced pain and improved mobility.
Indications
- Sudden sharp pain in the back of the ankle
- Difficulty walking or bearing weight on the affected leg
- Swelling and bruising in the lower leg
- A noticeable gap above the heel where the tendon is ruptured
- Inability to rise up on the toes of the injured leg
Preparation
- Fasting for at least 6-8 hours before the procedure
- Adjusting or stopping certain medications as advised by the doctor
- Pre-operative diagnostics, such as an MRI or ultrasound, to assess the extent of the rupture
- Blood tests and a physical examination to ensure overall fitness for surgery
Procedure Description
- Anesthesia Administration: Regional anesthesia (nerve block) or general anesthesia is given to ensure the patient is pain-free during the surgery.
- Incision: A small incision is made at the back of the ankle.
- Repair: The ruptured tendon ends are stitched back together. If the gap is large, a tendon graft, often taken from another part of the foot, may be used to bridge the gap.
- Closure: The incision is closed with stitches, and a bandage is applied.
- Immobilization: The leg is placed in a cast or boot to keep it immobile and aid healing.
Duration
The procedure typically takes 1-2 hours.
Setting
This surgery is generally performed in a hospital or a surgical center.
Personnel
- Orthopedic or specialized foot and ankle surgeon
- Anesthesiologist
- Surgical nurses
- Operating room technicians
Risks and Complications
- Infection at the incision site
- Nerve damage
- Blood clots
- Delayed wound healing
- Tendon re-rupture
- Adverse reactions to anesthesia
Benefits
- Restored functionality and strength to the injured leg
- Reduced pain and improved quality of life
- Increased ability to participate in physical activities
- Recovery of normal gait and movement
Recovery
- Follow-up appointments to monitor healing
- Physical therapy to restore strength and flexibility
- Wearing a cast or boot for several weeks
- Avoiding weight-bearing activities for a specified period
- Gradual return to normal activities as advised by the doctor
- Total recovery time can range from 6 months to a year
Alternatives
- Non-surgical treatments like physical therapy and bracing
- Conservative management with rest, ice, compression, and elevation (RICE)
- Pros of alternatives: Avoids surgical risks
- Cons of alternatives: May result in incomplete healing or reduced functionality
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, some discomfort and swelling are expected, which can be managed with pain medication. Stiffness and immobility in the leg are normal initially, with gradual improvement through physical therapy. Patience and adherence to the rehabilitation plan are crucial for optimal recovery.