26432 Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)

Name of the Procedure:

Closed Treatment of Distal Extensor Tendon Insertion, with or without Percutaneous Pinning (e.g., Mallet Finger)

Summary

This is a minimally invasive procedure to treat mallet finger, a condition where the fingertip droops because the extensor tendon is damaged. The procedure may involve immobilizing the finger with a splint or using a small pin inserted through the skin to hold the tendon in place as it heals.

Purpose

Addresses: Mallet finger Goals: To realign and stabilize the damaged extensor tendon, allowing it to heal properly and restore normal finger movement and function.

Indications

• Drooping fingertip (mallet finger)
• Loss of ability to extend the fingertip
• Tendon injury at the distal phalanx

Preparation

• No fasting required
• Inform physician about all medications and allergies
• Immobilize the finger with a temporary splint before the procedure
• Basic diagnostic X-ray to assess the injury

Procedure Description

1. The affected finger is numbed with local anesthesia.
2. The finger is immobilized, often with a splint.
3. If percutaneous pinning is necessary, a small pin is inserted through the fingertip to align and stabilize the tendon.
4. The pin is placed under fluoroscopy (a type of X-ray) for accuracy.
5. The finger is then put in a splint to maintain the proper position during healing.

Duration

Typically takes about 30 minutes to an hour.

Setting

Performed in an outpatient clinic or a minor procedure room in a surgical center.

Personnel

• Orthopedic surgeon or hand specialist
• Nursing staff
• Radiology technician (if fluoroscopy is used)

Risks and Complications

• Infection at the pin site
• Pin migration or displacement
• Tendon re-rupture
• Joint stiffness
• Skin irritation or breakdown from the splint

Benefits

• Proper tendon healing
• Restored extension of the fingertip
• Avoidance of more extensive surgery
• Typically, benefits are observed within 6-8 weeks of consistent splinting and care

Recovery

• Keep the finger immobilized in a splint for 6-8 weeks
• Follow up for pin removal if percutaneous pinning was performed
• Physical therapy exercises may be recommended to restore full range of motion
• Avoid heavy lifting or strenuous activities involving the injured finger

Alternatives

• Continuous splinting without pinning
• Surgical repair if the injury is severe
• Pros: Non-surgical methods avoid invasive risks; surgical options may be more definitive for severe cases.
• Cons: Non-surgical methods may require more time and strict compliance; surgical options have higher risks.

Patient Experience

• Minimal discomfort from local anesthesia
• Soreness around the pin site if pinning is performed
• Mild pain managed with over-the-counter pain relievers
• Temporary limitations in finger use until fully healed