Name of the Procedure:

Repair of Extensor Tendon of Hand (Primary or Secondary) with Free Graft (Including Obtaining Graft), Each Tendon

Summary

This procedure involves repairing a damaged or severed extensor tendon in the hand using a tendon graft from another part of the patient’s body. The tendon graft is used to bridge the gap caused by the injury, restoring function and movement to the affected tendon.

Purpose

Medical Condition: Tendon injuries or ruptures in the hand that affect the ability to extend the fingers. Goals: To restore the normal function and strength of the extensor tendons in the hand, enabling the patient to regain movement and dexterity.

Indications

• lacerated or severed extensor tendons.
• tendon damage due to trauma or repetitive strain injuries.
• loss of finger extension capability.
• suitable for patients fit for surgery and non-responsive to conservative treatments.

Preparation

• Fasting is typically required 6-8 hours before the procedure.
• Adjustments to current medications under guidance from a healthcare provider.
• Pre-operative physical examination and potentially imaging studies (e.g., MRI or ultrasound).

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A surgical incision is made over the damaged tendon area.
3. Graft Harvesting: A tendon graft is obtained from another part of the patient’s body, usually the foot or another part of the hand.
4. Repair: The graft is carefully placed and sewn into the damaged tendon using fine sutures.
5. Closure: The surgical site is closed with sutures and bandaged.

Tools may include surgical scissors, needle holders, sutures, and specialized instruments for tendon repair.

Duration

Typically, the procedure takes between 1 to 3 hours, depending on the complexity.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist
• Physician assistant or surgical technician

Risks and Complications

• Infection at the incision site
• Bleeding or hematoma
• Nerve damage
• Stiffness or limited range of motion
• Graft rejection or failure
• Scar tissue formation

Benefits

• Restored finger extension and hand function
• Reduced pain and discomfort
• Improved quality of life and ability to perform daily activities Benefits are typically realized within a few weeks to a few months post-surgery, depending on the individual healing process.

Recovery

• Immobilization of the hand in a splint or cast for a few weeks.
• Gradual mobilization through physical therapy.
• Pain management with prescribed medications.
• Regular follow-up appointments to monitor healing.

Complete recovery can take several months, with ongoing physical therapy recommended to regain full strength and flexibility.

Alternatives

• Non-surgical options such as physical therapy, occupational therapy, or splinting.
• Tendon transfer surgery (if appropriate).
• Non-invasive treatments generally have a lower success rate in severe tendon injuries.

Patient Experience

Patients can expect some discomfort and pain post-procedure, managed with analgesics. Swelling and bruising are common, and the hand must be kept elevated. Full participation in physical therapy is crucial for optimal recovery, as is adhering to post-operative care instructions.