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Lengthening of tendon, extensor, hand or finger, each tendon

CPT4 code

Name of the Procedure:

Lengthening of tendon, extensor, hand or finger, each tendon
Common name(s): Tendon Lengthening Surgery, Extensor Tendon Lengthening

Summary

Tendon lengthening surgery involves the surgical extension of the tendons in the hand or fingers. This procedure can help improve movement and function in the affected area.

Purpose

The surgery addresses issues like tendon contracture or shortening, which can limit motion and cause discomfort. The goal is to restore a normal range of motion and alleviate associated symptoms.

Indications

  • Symptoms: Limited range of motion, stiffness, difficulty in finger or hand movements.
  • Conditions: Tendon contractures due to injury, cerebral palsy, or chronic conditions.
  • Patient Criteria: Individuals with persistent functional impairment not responsive to conservative treatments.

Preparation

  • Pre-Procedure Instructions: Fasting for 6-8 hours prior to surgery; stopping certain medications as advised by the surgeon.
  • Diagnostic Tests: Imaging tests like X-rays or MRIs to assess the tendon condition.

Procedure Description

  1. Administration of local or general anesthesia.
  2. A small incision is made to expose the tendon.
  3. Surgical tools are used to carefully lengthen the tendon to the desired length.
  4. Incision is closed with sutures.
  5. The hand or finger is bandaged and often splinted for stabilization.

Duration

Typically, the procedure takes between 30 minutes to 1 hour per tendon.

Setting

The procedure is usually performed in an outpatient surgical center or a hospital.

Personnel

  • Surgeon (typically an orthopedic or plastic surgeon)
  • Anesthesiologist (for general anesthesia cases)
  • Surgical nurses and assistants

Risks and Complications

  • Common Risks: Infection, swelling, pain at the surgery site.
  • Rare Complications: Nerve damage, excessive bleeding, tendon rupture, poor wound healing.

Benefits

  • Improved range of motion in the hand or finger.
  • Alleviation of discomfort or pain associated with the tendon condition.
  • Enhanced functional ability, often noticeable within a few weeks post-surgery.

Recovery

  • Post-Procedure Care: Wound care, pain management with prescribed medications.
  • Expected Recovery Time: 4-6 weeks, with potential ongoing physical therapy.
  • Restrictions: Limited hand or finger movement, avoiding strenuous activities until cleared by the doctor.
  • Follow-Up: Regular appointments to monitor healing and progress.

Alternatives

  • Physical Therapy: Might improve mild tendon shortening.
  • Orthoses: Splints or braces to aid in movement.
  • Medications: Anti-inflammatory drugs for symptom relief.
  • Pros and Cons: Non-surgical options are less invasive but may not offer permanent resolution compared to surgery.

Patient Experience

  • During Procedure: No pain during the procedure due to anesthesia.
  • After Procedure: Some pain and discomfort expected, manageable with medications.
  • Pain Management: Prescription painkillers or over-the-counter pain relief, cold compresses to reduce swelling.
  • Comfort Measures: Elevating the hand, using pillows for support, maintaining proper wound care.

This markdown description provides a comprehensive yet straightforward guide to understanding the lengthening of extensor tendons in the hand or finger, covering all relevant aspects from purpose to patient experience.

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