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Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, including fascial or tendon graft

CPT4 code

Name of the Procedure:

Suture of Quadriceps or Hamstring Muscle Rupture; Secondary Reconstruction, including Fascial or Tendon Graft

Summary

This procedure involves repairing a ruptured quadriceps or hamstring muscle using sutures and possibly grafts from fascia or tendons. It is performed to restore the normal function of the muscle after severe injury.

Purpose

  • Address the tearing of the quadriceps or hamstring muscle.
  • Restore muscle strength, functionality, and range of motion.
  • Improve overall limb function and mobility.

Indications

  • Severe muscle tears that cannot heal naturally.
  • Persistent weakness or loss of function in the affected limb.
  • Patients who have not responded to conservative treatments like physical therapy.

Preparation

  • Fasting for at least 6-8 hours before the procedure if general anesthesia is used.
  • Adjusting current medications as advised by the healthcare provider.
  • Pre-operative imaging tests such as MRI or ultrasound to evaluate the extent of the injury.

Procedure Description

  1. The patient is given anesthesia (general or regional).
  2. An incision is made over the site of the muscle rupture.
  3. The torn muscle fibers are identified and sutured back together.
  4. If necessary, a graft from adjacent fascia or tendon is harvested and used to reinforce the repair.
  5. The incision is then closed with sutures or staples, and a sterile dressing is applied.

Tools and Equipment:

  • Surgical instruments for incising and suturing.
  • Tendon/fascia harvesting tools.
  • Imaging tools for guidance, if required.

Anesthesia:

  • Generally involves general anesthesia but may also include regional anesthesia.

Duration

The procedure typically takes 1-3 hours, depending on the severity of the rupture and the complexity of the repair.

Setting

  • Hospital operating room or specialized surgical center.

Personnel

  • Orthopedic surgeon or specialized surgical team.
  • Anesthesiologist.
  • Surgical nurses and assistants.

Risks and Complications

  • Infection at the surgical site.
  • Blood clots.
  • Nerve damage.
  • Incomplete healing or failure of the graft.
  • Surgical complications related to anesthesia.

Benefits

  • Restoration of muscle strength and function.
  • Improved mobility and quality of life.
  • Reduced pain and discomfort from the injury.

Recovery

  • Post-surgery hospitalization for monitoring, usually 1-2 days.
  • Pain management using prescribed medications.
  • Physical therapy starts after initial healing, often within a few weeks.
  • Full recovery can take from several weeks to a few months, depending on the individual's health and adherence to rehabilitation.

Alternatives

  • Non-surgical management with physical therapy and pain management, though often not effective for severe tears.
  • Tendon transfers or other surgical techniques which may vary in invasiveness and recovery time.

Patient Experience

  • Patients may feel pain and discomfort immediately after the procedure, managed by pain medication.
  • Swelling and bruising around the surgical site.
  • Gradual improvement in muscle function and reduction of pain with ongoing physical therapy.
  • Patients are advised to follow all post-operative care instructions to ensure optimal recovery.

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