Realignment of extensor tendon, hand, each tendon
CPT4 code
Name of the Procedure:
Realignment of Extensor Tendon, Hand, Each Tendon
Common name(s): Extensor Tendon Repair, Tendon Realignment Surgery
Summary
Realignment of the extensor tendon in the hand is a surgical procedure to correct a misaligned or damaged tendon that extends the fingers and thumb. This surgery aims to restore proper function and alleviate pain or dysfunction in the hand.
Purpose
This procedure addresses conditions like extensor tendon injuries, deformities, or malfunctions in the hand. The goal is to realign the tendons to enable normal finger extension, reduce pain, and restore hand function.
Indications
- Traumatic injury to the extensor tendons
- Tendon lacerations or ruptures
- Malalignment causing decreased hand functionality
- Chronic pain or deformity due to tendon issues
- Lack of response to conservative treatments like splinting or physical therapy
Preparation
- Preoperative consultation to discuss medical history and review any medications
- Fasting several hours before the procedure, typically starting the night before
- Special instructions for patients on blood-thinning medications
- Diagnostic imaging, such as X-rays or ultrasound, to assess the extent of the tendon damage
Procedure Description
- The patient is placed under local or general anesthesia, depending on the case’s complexity.
- A tourniquet may be applied to the upper arm to reduce blood flow to the hand.
- An incision is made near the site of the tendon damage.
- The surgeon uses specialized tools to locate and realign the extensor tendon.
- The tendon is repaired or reattached as needed, often using sutures or other fixation methods.
- The surgeon closes the incision with stitches and may apply a sterile dressing or splint.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity and number of tendons involved.
Setting
This surgery is usually performed in a hospital or an outpatient surgical center.
Personnel
- Orthopedic or hand surgeon
- Surgical nurse
- Anesthesiologist or anesthesia provider
- Surgical technician
Risks and Complications
- Infection at the incision site
- Tendon re-rupture or failure to heal properly
- Scarring or stiffness
- Nerve damage leading to numbness or tingling
- Adverse reactions to anesthesia
- Prolonged swelling or pain
Benefits
- Restores finger extension and hand function
- Reduces pain and discomfort
- Improves the ability to perform daily activities
- Quick and effective recovery when postoperative instructions are followed
Recovery
- Initial recovery involves rest and protecting the hand with a splint or cast.
- Patients are advised to follow a physical therapy regimen to regain strength and flexibility.
- Full recovery typically takes several weeks to a few months, with follow-up appointments to assess progress.
- Patients may need to avoid heavy lifting or strenuous activities during the recovery period.
Alternatives
- Nonsurgical treatments like splinting, physical therapy, or corticosteroid injections (may not be effective for severe cases)
- Tendon grafts or reconstruction in cases where simple realignment isn’t sufficient
- Pros and cons include varying recovery times, efficacy rates, and risks of complications.
Patient Experience
During the procedure, the patient may be awake with local anesthesia or asleep under general anesthesia. Postoperatively, there may be pain and swelling managed with pain medications and anti-inflammatory drugs. It is common to experience some discomfort, which typically improves within a few days. Patients are given detailed aftercare instructions to facilitate recovery and optimize the surgical outcome.