26390 Excision flexor tendon, with implantation of synthetic rod for delayed tendon graft, hand or finger, each rod

Name of the Procedure:

Excision Flexor Tendon, with Implantation of Synthetic Rod for Delayed Tendon Graft, Hand or Finger (each rod)

Summary

This procedure involves removing a damaged flexor tendon in the hand or finger and implanting a synthetic rod as a temporary placeholder. The rod is used to maintain space and facilitate healing until a tendon graft can be performed at a later date.

Purpose

Medical Condition or Problem Addressed

• Severe flexor tendon injuries or ruptures in the hand or fingers. ##### Goals or Expected Outcomes
• To maintain the structure of the area for future tendon grafting.
• To ensure proper healing and function of the hand or finger by providing a stable environment.

Indications

Symptoms or Conditions Warranting the Procedure

• Significant injury or damage to one or more flexor tendons in the hand or fingers.
• Persistent pain, limited range of motion, or loss of function due to tendon damage. ##### Patient Criteria
• Patients who are not candidates for immediate tendon grafting.
• Individuals requiring a staged approach to tendon repair and reconstruction.

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to medications, especially blood thinners, may be necessary.
• Preoperative diagnostic tests, such as X-rays or MRI, to assess the extent of tendon damage.

Procedure Description

1. The patient is given anesthesia, typically either regional (e.g., nerve block) or general anesthesia.
2. An incision is made over the area of the damaged tendon.
3. The damaged tendon is carefully excised and removed.
4. A synthetic rod is implanted in the space previously occupied by the tendon.
5. The incision is closed with sutures, and the area is bandaged.
   • Tools may include surgical knives, special retractors, and synthetic rods.
   • The procedure is performed under sterile conditions to prevent infection.

Duration

• The procedure typically takes about 1 to 2 hours, depending on the extent of the tendon damage and complexity of the case.

Setting

• Usually performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic or plastic surgeons specializing in hand surgery.
• Anesthesiologist or nurse anesthetist.
• Surgical nurses and technicians.

Risks and Complications

• Common risks: Infection, bleeding, and swelling.
• Rare risks: Damage to nearby nerves or blood vessels, allergic reaction to anesthesia, failure of the synthetic rod to maintain the space.
• Possible complications: Delayed healing, scarring, need for additional surgeries.

Benefits

• Maintains proper alignment and space for future tendon grafting.
• Facilitates more successful and functional results in subsequent tendon graft surgeries.
• Reduction in pain and improved function post-recovery.

Recovery

• Post-procedure care includes keeping the hand or finger immobilized with a splint or cast.
• Pain management typically involves prescribed medications.
• Physical therapy may be recommended to maintain mobility and reduce stiffness.
• Full recovery and readiness for the tendon graft may take several weeks to months.

Alternatives

• Immediate tendon grafting, though not always feasible.
• Conservative treatments such as physical therapy and bracing, which may not be sufficient for severe tendon injuries.
• Pros of alternatives: Immediate tendon grafting can restore function quicker.
• Cons of alternatives: Higher risk of complications if the site isn't prepared properly.

Patient Experience

• During the procedure: The patient will be under anesthesia and should not feel pain.
• After the procedure: Mild to moderate pain managed with medications.
• Swelling and bruising are common and should subside over time.
• Physical therapy may be uncomfortable initially but is crucial for recovery.
• It is essential for patients to follow post-operative care instructions to ensure proper healing.

This markdown text provides a thorough overview of the excision of a flexor tendon with implantation of a synthetic rod for delayed tendon graft in the hand or finger, making it suitable for inclusion in medical documents or patient education materials.