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Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon

CPT4 code

Name of the Procedure:

Tendon Transplantation or Transfer, Flexor or Extensor, Forearm and/or Wrist, Single; Each Tendon

Summary

Tendon transplantation or transfer involves moving a tendon from one part of the forearm or wrist to another to restore function. This procedure is typically used to repair damaged or ruptured tendons, either from injury or disease.

Purpose

This procedure addresses tendon injuries or conditions where tendons are damaged or non-functional. The goal is to restore mobility and strength to the affected part of the forearm or wrist, allowing the patient to regain hand and wrist functions.

Indications

  • Torn or ruptured tendons in the forearm or wrist.
  • Chronic tendonitis or tendinopathy not responding to other treatments.
  • Conditions such as rheumatoid arthritis that cause tendon degeneration.
  • Loss of function due to nerve injury affecting tendon control.

Preparation

  • Fasting may be required several hours before the procedure.
  • Patients might need to adjust or stop certain medications under the doctor’s guidance.
  • Pre-operative diagnostic tests may include X-rays, MRI, or ultrasound to assess the tendon damage.

Procedure Description

  1. Anesthesia: General or regional anesthesia is administered.
  2. Incision: A small incision is made near the damaged tendon.
  3. Tendon Identification: Healthy tendon is identified, usually from a nearby area.
  4. Transplant or Transfer: The healthy tendon is detached from its original place and attached to the area of the damaged tendon.
  5. Suturing: The tendons are carefully stitched together, and the incision is closed.
  6. Immobilization: The area may be immobilized with a splint or cast to facilitate healing.

Tools used include surgical blades, tendon graspers, sutures, and immobilization devices like splints or casts.

Duration

The procedure typically takes 1 to 2 hours.

Setting

The procedure is performed in a hospital or surgical center.

Personnel

  • Orthopedic or plastic surgeon
  • Surgical nurse
  • Anesthesiologist
  • Surgical technologist

Risks and Complications

  • Infection
  • Scarring
  • Nerve damage
  • Blood clots
  • Stiffness or reduced mobility
  • Failure of the tendon to heal properly

Benefits

  • Restored function and mobility in the wrist or forearm.
  • Pain relief.
  • Improved quality of life and ability to perform daily activities.

Recovery

  • Immobilization of the affected area for several weeks.
  • Physical therapy to regain strength and flexibility.
  • Follow-up appointments to monitor healing.
  • Full recovery is typically expected within 3 to 6 months.
  • Restrictions on heavy lifting or strenuous activities until fully healed.

Alternatives

  • Physical therapy
  • Orthotic devices
  • Pain management with medication or injections
  • Other surgical options such as tendon repair or grafting

Patient Experience

  • Anesthesia will prevent pain during the procedure.
  • Post-surgery, there may be discomfort, managed with pain medications.
  • Initial soreness and limited mobility, improving with rehabilitation.
  • The patient will gradually regain function as healing progresses.

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