26548 Repair and reconstruction, finger, volar plate, interphalangeal joint

Name of the Procedure:

Repair and Reconstruction of Finger, Volar Plate, Interphalangeal Joint

Summary

This procedure involves surgically repairing and reconstructing the volar plate, a ligamentous structure on the palm side of a finger's interphalangeal joint. This surgery aims to restore joint stability and function following an injury.

Purpose

The purpose of this procedure is to address injuries to the volar plate, typically due to hyperextension or trauma. The goals are to stabilize the joint, prevent further injury or deformity, and restore as much function and mobility to the finger as possible.

Indications

• Hyperextension injuries or dislocations of the finger
• Volar plate tears or ruptures
• Chronic instability or pain in the interphalangeal joint
• Failed conservative treatments, such as splinting or physical therapy

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Adjustment of current medications may be required.
• Preoperative imaging studies like X-rays or MRI scans to assess the extent of injury.

Procedure Description

1. The patient is typically given regional anesthesia or sedation.
2. An incision is made on the volar side of the finger.
3. The surgeon carefully identifies and assesses the damaged volar plate.
4. The torn or damaged volar plate is repaired using sutures or other reconstructive techniques.
5. In some cases, additional structures such as tendons or ligaments are repaired to ensure stability.
6. The incision is closed with sutures, and the finger is bandaged.

Duration

The procedure usually takes about 1 to 2 hours.

Setting

The surgery is generally performed in a hospital or specialized outpatient surgical center.

Personnel

• Orthopedic or hand surgeon
• Surgical nurses
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection
• Bleeding
• Stiffness or reduced mobility of the finger
• Nerve or vascular injury
• Recurrent instability or need for additional surgery

Benefits

• Restored stability and function of the finger joint
• Reduction or elimination of pain
• Prevention of long-term deformity
• Improved quality of life and hand function

Recovery

• Post-procedure, the finger may be immobilized in a splint or cast.
• Elevation and icing of the finger to reduce swelling.
• Pain management with prescribed medications.
• Physical therapy might be recommended to restore motion and strength.
• Full recovery typically takes several weeks to months, with gradual return to normal activities.

Alternatives

• Non-surgical treatments like splinting, bracing, or physical therapy.
• Corticosteroid injections for pain and inflammation.
• Pros: Less invasive, lower immediate risk.
• Cons: May not provide permanent or complete resolution, especially in severe cases.

Patient Experience

During the procedure, the patient will often feel minimal or no pain due to anesthesia. Postoperatively, patients might experience discomfort and swelling, which can be managed with medications. Physical therapy may be necessary to regain full function, and adherence to rehabilitation protocols is crucial for a successful recovery.