Sesamoidectomy, thumb or finger (separate procedure)
CPT4 code
Name of the Procedure:
Sesamoidectomy, thumb or finger (separate procedure)
Common Name: Sesamoid Bone Removal
Technical Term: Phalangeal Sesamoidectomy
Summary
A sesamoidectomy is a surgical procedure involving the removal of one or both sesamoid bones from the thumb or finger. These bones are small, round, and embedded within tendons, playing a crucial role in the mechanics of the hand.
Purpose
The procedure aims to relieve pain, inflammation, or dysfunction caused by sesamoid bone injuries or abnormalities. Conditions such as sesamoiditis, fractures, or osteoarthritis may necessitate this intervention. The goal is improved hand function and pain relief.
Indications
- Chronic pain in the thumb or finger unresponsive to conservative treatments
- Sesamoid fractures
- Sesamoiditis (chronic inflammation)
- Osteoarthritis or degeneration of the sesamoid bone
- Limited hand or finger function due to sesamoid issues
Preparation
- Fasting for 6-8 hours prior if general anesthesia is planned
- Adjustment or cessation of certain medications as advised by the doctor
- Blood tests and imaging studies (X-rays, MRI) to assess the sesamoid bones
- Preoperative consultation with the surgeon and anesthesiologist
Procedure Description
- The patient is brought to the operating room and prepped for surgery.
- Anesthesia is administered; this may be local, regional, or general depending on the case.
- The surgeon makes an incision over the affected thumb or finger.
- Soft tissues and tendons are carefully moved to expose the sesamoid bone.
- The sesamoid bone is removed, ensuring minimal disruption to surrounding structures.
- The incision is closed with sutures, and a sterile dressing is applied.
Tools/Equipment Used: Scalpel, retractors, small bone instruments, suturing materials
Anesthesia: Local, regional, or general anesthesia may be used
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurses
- Anesthesiologist or anesthesia provider
- Surgical technologist
Risks and Complications
- Infection
- Bleeding or hematoma
- Nerve damage
- Stiffness or reduced range of motion in the thumb or finger
- Recurrence of pain or new pain
- Scar formation
Benefits
- Relief from pain and inflammation
- Improved function and mobility of the thumb or finger
- Enhanced quality of life and ability to perform daily activities
Recovery
- Immobilization of the thumb or finger with a splint or cast for several weeks
- Pain management with prescribed medications
- Instructions for wound care and signs of infection
- Physical therapy to restore strength and flexibility
- Follow-up appointments to monitor healing and progress
Alternatives
- Non-surgical treatments: Rest, ice, anti-inflammatory medications, physical therapy
- Corticosteroid injections for inflammation
- Alternative surgeries (e.g., excision of other soft tissue abnormalities)
Pros: Less invasive, short recovery time
Cons: May not be effective for severe cases or persistent conditions
Patient Experience
During the procedure, depending on the type of anesthesia, the patient may be awake but numb, or completely asleep. Postoperatively, there may be pain, swelling, and bruising, which can be managed with medications. With proper care, gradual improvement is expected, leading to full recovery and resumption of normal activities.