Name of the Procedure:

Repair, flexor tendon, leg; secondary, with or without graft, each tendon

Summary

In this procedure, the surgeon repairs a damaged or torn flexor tendon in the leg. This is a secondary repair, meaning it addresses issues from previous surgery or injury. Sometimes, a graft is used to replace or support the damaged tendon.

Purpose

The procedure is aimed at restoring function to the leg by repairing the flexor tendons, which are crucial for bending the toes and foot. It can relieve pain, improve mobility, and enhance the overall quality of life for the patient.

Indications

• Persistent pain or dysfunction in the leg due to a damaged flexor tendon.
• Failed primary repair or recurring tendon injuries.
• Difficulty in bending the toes or foot.
• Significant tendon degeneration or scarring.

Preparation

• Fasting for at least 8 hours before the procedure if general anesthesia is used.
• Adjustment or temporary discontinuation of certain medications, as advised by the doctor.
• Preoperative tests, such as blood tests, X-rays, or MRI, to assess the tendon damage.

Procedure Description

1. The patient is administered either regional (spinal or epidural) or general anesthesia.
2. An incision is made over the affected area in the leg.
3. Scar tissue or damaged tendon segments are carefully removed.
4. The tendon ends are repaired using sutures, sometimes augmented with a graft from another part of the patient's body or a donor graft.
5. The incision is closed with stitches.
6. The leg may be immobilized with a splint or cast to promote healing.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity of the repair.

Setting

This surgery is usually performed in a hospital or a specialized outpatient surgical center.

Personnel

• Orthopedic surgeon specialized in tendon repair
• Anesthesiologist
• Surgical nurses and technicians
• Physiatrist or physical therapist for post-surgical care

Risks and Complications

• Infection at the incision site
• Blood clots
• Nerve damage
• Tendon rupture or failure to heal properly
• Chronic pain or stiffness
• Complications from anesthesia

Benefits

• Restored function and mobility in the affected leg.
• Reduction of pain and discomfort.
• Improved quality of life and independence in daily activities.
• Benefits typically begin to be realized a few weeks post-surgery as the tendon heals.

Recovery

• Initial immobilization of the leg and usage of crutches to avoid weight-bearing.
• Pain management with prescribed medications.
• Physical therapy starting a few weeks post-procedure to regain strength and flexibility.
• Full recovery may take 3 to 6 months, with gradual increase in activity level.

Alternatives

• Non-surgical options, such as physical therapy, medication, or orthotic devices, which may provide symptom relief but do not repair the tendon.
• Primary tendon repair if it has not been previously attempted.
• Arthroscopic tendon debridement.
• Each alternative has varying levels of effectiveness and recovery time compared to secondary repair with graft.

Patient Experience

• The patient may experience mild to moderate pain post-surgery, which can be managed with medications.
• There might be swelling and bruising around the incision site.
• Gradual improvement in movement and reduction in pain as healing progresses.
• Physical therapy sessions may cause some discomfort but are vital for a successful recovery.