Repair or advancement of profundus tendon, with intact superficialis tendon; secondary without free graft, each tendon
CPT4 code
Name of the Procedure:
Repair or Advancement of Profundus Tendon with Intact Superficialis Tendon; Secondary Without Free Graft, Each Tendon. Commonly known as "Flexor Digitorum Profundus (FDP) Tendon Repair."
Summary
This procedure involves repairing or advancing the flexor digitorum profundus (FDP) tendon in a finger, while leaving the superficialis tendon intact. It is done without using a graft and typically follows an earlier (secondary) surgery.
Purpose
The procedure is performed to restore function and movement to a finger with a damaged FDP tendon. It aims to enable the patient to flex the finger properly and regain hand functionality.
Indications
- Partial or complete FDP tendon tears.
- Difficulty flexing the finger at the distal joint.
- Past trauma or injury to the tendon.
- Functional impairment affecting daily activities.
Preparation
- Fasting may be required if general anesthesia is used.
- Adjustments to regular medications, particularly blood thinners.
- Preoperative diagnostic tests such as X-rays or MRI.
Procedure Description
- The patient is usually given local or general anesthesia.
- An incision is made near the affected tendon.
- The FDP tendon is carefully examined and debrided.
- The tendon ends are stitched together or advanced to reattach to the bone, without using a graft.
- The incision is closed with sutures.
- The hand may be splinted to immobilize it for healing.
Tools and equipment include surgical scalpels, sutures, and specialized tendon repair tools.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity.
Setting
Performed in a hospital operating room or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon.
- Surgical nurses.
- Anesthesiologist (if general anesthesia is used).
Risks and Complications
- Infection at the surgical site.
- Scar tissue formation.
- Tendon re-rupture or failure.
- Stiffness and loss of finger motion.
- Anesthesia-related risks.
Benefits
- Restored finger flexion and hand functionality.
- Improved ability to perform daily tasks.
- Pain relief and enhanced quality of life. Benefits may become noticeable within weeks to months post-surgery.
Recovery
- Follow strict immobilization guidelines for a few weeks.
- Physical therapy to regain strength and mobility.
- Monitor for signs of infection or complications.
- Recovery ranges from several weeks to a few months.
Alternatives
- Conservative management with physical therapy and splinting.
- Primary tendon repair or grafting.
- Each alternative has varying success rates and recovery times.
Patient Experience
- May experience postoperative pain managed with medication.
- Initial discomfort due to immobilization.
- Gradual improvement in function with diligent rehabilitation and physical therapy.
- Follow-up visits to monitor progress and adjust therapy as needed.