Excision of tendon, finger, flexor or extensor, each tendon
CPT4 code
Name of the Procedure:
Excision of Tendon, Finger, Flexor or Extensor
Common name(s): Tendon Removal Surgery, Tendon Excision Surgery
Medical term: Tendonectomy
Summary
Tendon excision surgery involves removing a damaged or diseased tendon from a finger. This procedure can involve either the flexor or extensor tendons, which are responsible for bending and straightening the finger, respectively.
Purpose
Excision of a tendon is performed to alleviate pain, restore function, or prevent further damage in cases where a tendon is significantly damaged or diseased. The goal is to improve finger mobility and function.
Indications
- Severe tendon damage due to traumatic injury
- Chronic tendonitis that does not respond to conservative treatment
- Tendon rupture
- Deformity or dysfunction caused by conditions like rheumatoid arthritis
Preparation
- Pre-procedure fasting (usually for 8-12 hours prior if general anesthesia is used)
- Adjustment or temporary discontinuation of certain medications (such as blood thinners)
- Diagnostic tests such as X-rays or MRIs to assess the extent of tendon damage
Procedure Description
- The patient is positioned for optimal access to the affected finger.
- Local or general anesthesia is administered.
- A surgical incision is made over the affected area.
- The surgeon carefully isolates and excises the damaged tendon.
- The incision is closed with sutures or surgical staples.
- A protective bandage or splint is applied to the finger.
Tools used: Scalpel, surgical scissors, clamps, sutures/staples
Anesthesia: Local or general anesthesia will be used depending on the specifics of the case.
Duration
The procedure typically takes between 30 minutes to 1 hour.
Setting
The procedure is usually performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Anesthesiologist (if general anesthesia is used)
- Surgical nurses and technicians
Risks and Complications
- Infection
- Bleeding
- Nerve damage
- Scar tissue formation
- Reduced finger mobility or stiffness
- Prolonged pain or swelling
Benefits
- Reduced pain and discomfort
- Improved finger function and mobility
- Prevention of further tendon damage
- Enhancement of quality of life
Recovery
- Post-procedure care includes keeping the surgical area clean and dry.
- Pain management typically involves prescribed pain relief medication.
- Physical therapy may be recommended to restore mobility and strength.
- Most patients can resume normal activities within a few weeks, but full recovery may take several months.
- Follow-up appointments to monitor healing progress.
Alternatives
- Non-surgical treatments such as physical therapy, splinting, and medications.
- Tendon repair surgery instead of excision, where the damaged tendon is sutured.
- Pros and cons: Non-surgical options are less invasive but may not be effective for severe cases; tendon repair may preserve the tendon but might not be suitable if the tendon is too damaged.
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel pain. Post-procedure, there might be discomfort, swelling, and limited movement, all of which can be managed through pain medication and care recommendations from the healthcare team.