26392 Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod

Name of the Procedure:

Removal of Synthetic Rod and Insertion of Flexor Tendon Graft, Hand or Finger

Summary

This surgical procedure involves removing a pre-existing synthetic rod from a tendon in the hand or finger and replacing it with a graft taken from another part of the body. This can help restore movement and function to the affected area.

Purpose

This procedure addresses damaged or non-functional tendons in the hand or finger. The goals are to restore tendon integrity, improve range of motion, and reduce pain.

Indications

• Severe tendon damage or rupture in the hand or finger.
• Previous unsuccessful tendon repair.
• Persistent pain or loss of function due to a synthetic rod.
• High demands for hand function in daily activities or occupation.

Preparation

• Fasting typically starts 6-8 hours before the procedure.
• Adjustments to current medications may be needed (e.g., blood thinners).
• Preoperative imaging (e.g., MRI, ultrasound) to assess tendon damage.
• Complete preoperative assessments and discussions with the surgical team.

Procedure Description

1. Patient receives anesthesia (local, regional, or general).
2. Incision made on the hand or finger to expose the synthetic rod.
3. Synthetic rod carefully removed.
4. Tendon graft harvested, usually from the patient's own leg (plantaris or palmaris longus tendon).
5. Graft prepared and inserted into the hand or finger.
6. Tendon graft anchored in place using sutures or other fixation methods.
7. Incisions closed with sutures and covered with sterile dressings.

Duration

Typically, the procedure lasts 2-3 hours.

Setting

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

Personnel

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

Risks and Complications

• Infection at the surgical site.
• Bleeding or hematoma formation.
• Nerve damage leading to numbness or weakness.
• Graft failure or rejection.
• Stiffness or limited range of motion post-surgery.

Benefits

• Improved tendon function and hand mobility.
• Reduced pain and discomfort.
• Enhanced ability to perform daily tasks and occupational duties.

Recovery

• Immobilization of the affected hand or finger with a splint or cast for several weeks.
• Physical therapy to regain motion and strength.
• Regular follow-up appointments to monitor healing.
• Typical full recovery may take several months.

Alternatives

• Conservative management with physical therapy.
• Use of other tendon repair techniques or synthetic implants.
• Pros: Less invasive, reduced surgical risks.
• Cons: May not be as effective for severe tendon damage.

Patient Experience

During the procedure, the patient is under anesthesia, so they will not feel pain. Postoperatively, pain and swelling can be managed with medications. Physical therapy plays a crucial role in the recovery process.