Name of the Procedure:

Repair, Extensor Tendon, Finger, Primary or Secondary; with Free Graft (Includes Obtaining Graft) Each Tendon

Summary

This procedure involves repairing a damaged extensor tendon in the finger using a free graft. The graft, often taken from another part of the patient's body, replaces the damaged tendon tissue to restore finger movement.

Purpose

This procedure is performed to address injuries or damage to the extensor tendons in the fingers. The goal is to restore normal finger movement and function, alleviating pain and improving the patient’s ability to perform daily activities.

Indications

• Finger deformities due to tendon injury or rupture.
• Loss of finger range of motion or strength.
• Chronic tendon tears or damage that have not healed properly.
• Traumatic injuries to the hand or fingers.

Preparation

• Patients may need to fast for a certain period before the procedure.
• Adjustments may be made to medications, such as blood thinners.
• Pre-surgical imaging and diagnostic tests, like X-rays or MRIs, to assess the extent of tendon damage.
• Discussion of medical history, allergies, and any prior surgeries.

Procedure Description

1. Anesthesia: Administered to ensure the patient is comfortable and pain-free.
2. Incision: A surgical cut is made over the damaged extensor tendon.
3. Graft Harvesting: A tendon graft is harvested from another part of the patient's body, often the forearm or lower leg.
4. Tendon Repair: The damaged tendon is repaired, and the graft is used to replace the damaged section.
5. Anchoring the Graft: The graft is sutured into place to ensure it is secure.
6. Closure: The incision is closed using sutures, and a sterile dressing is applied.
   • Specialized surgical tools and equipment are used throughout the procedure.

Duration

The procedure typically takes around 1 to 2 hours, but this can vary based on the severity of the injury and surgical complexity.

Setting

This procedure is usually performed in a hospital or surgical center.

Personnel

• A skilled orthopedic or hand surgeon.
• Surgical nurses assisting during the procedure.
• An anesthesiologist or nurse anesthetist to manage anesthesia.

Risks and Complications

• Infection at the surgical site.
• Tendon re-rupture or failure of the graft.
• Scarring and stiffness in the finger.
• Nerve damage leading to numbness or weakness.
• Anesthesia-related risks.

Benefits

• Improved finger movement and function.
• Relief from pain associated with tendon injury.
• Enhanced ability to perform daily tasks.
• Increased strength and range of motion in the affected finger.

Recovery

• Post-operative care includes keeping the hand elevated and immobilized.
• Pain management with prescribed medications.
• Instructions on wound care and signs of infection to watch for.
• Physical therapy may be required to regain full function.
• Recovery time varies but generally ranges from a few weeks to several months.

Alternatives

• Non-surgical options like splinting, physical therapy, or injections.
• Primary repair without a graft for less severe injuries.
• Cons: Alternative treatments may not fully restore function or alleviate symptoms as effectively as the described procedure.

Patient Experience

During the procedure, patients will be under anesthesia and should feel no pain. Post-operation, some discomfort, swelling, and stiffness are expected. Pain is managed with medications, and comfort measures like ice packs and elevation can help alleviate symptoms. Regular follow-up appointments will ensure proper healing and rehabilitation.