Excision of tendon, palm, flexor or extensor, single, each tendon
CPT4 code
Name of the Procedure:
Excision of tendon, palm, flexor or extensor, single, each tendon.
Common name(s): Tendon Excision, Flexor/Extensor Tendon Removal, Palmar Tendon Excision.
Summary
This procedure involves surgically removing a damaged or diseased tendon from the palm of the hand. It can involve either one of the flexor (which bend the fingers) or extensor tendons (which straighten the fingers).
Purpose
This procedure addresses conditions such as severe tendon injuries, chronic inflammation, or tendon tumors in the palm. The goal is to alleviate pain, restore hand function, and prevent further complications.
Indications
- Severe tendon injuries or lacerations
- Chronic tenosynovitis
- Tendon tumors
- Unsuccessful conservative treatments for chronic pain or dysfunction
- Loss of hand function due to tendon damage
Preparation
- Patients may need to fast for a certain period before the procedure.
- Medication adjustments, especially for blood thinners.
- Pre-procedure diagnostics such as imaging (X-rays, MRI) and blood tests.
Procedure Description
- The patient is positioned, and the surgical area is cleaned and sterilized.
- Local or general anesthesia is administered.
- An incision is made in the palm to expose the damaged tendon.
- The surgeon carefully excises the affected tendon.
- The incision is closed with sutures.
- The hand is then bandaged and immobilized, if necessary.
Tools: Surgical scalpel, forceps, sutures, sterile drapes.
Anesthesia: Local or general anesthesia, depending on the case.
Duration
Typically, the procedure takes about 30 minutes to 1 hour.
Setting
The procedure is performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurse
- Anesthesiologist (for general anesthesia)
- Operating room technician
Risks and Complications
- Infection
- Bleeding
- Nerve damage
- Stiffness or reduced range of motion
- Scar formation
- Recurrence of the underlying condition
Benefits
- Pain relief
- Improved hand function
- Prevention of further tendon damage or complications
- Enhanced quality of life
Recovery
- Post-operative care includes pain management, avoiding heavy use of the hand, and following wound care instructions.
- Recovery time varies but usually spans several weeks; physical therapy may be needed.
- Follow-up appointments are essential to monitor healing and address any complications.
Alternatives
- Conservative treatments (physical therapy, medications, splinting)
- Tendon repair (if suitable)
- Non-surgical management options such as corticosteroid injections
Patient Experience
During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, there might be discomfort or pain, which can be managed with medications. Swelling and stiffness are common initially, and recovery involves follow-up visits, possible physical therapy, and adherence to activity restrictions.