Name of the Procedure:

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

Summary

This procedure involves the surgical repair of a damaged or torn extensor tendon in the leg. It can be performed as a secondary operation, meaning it follows an initial treatment or injury. The repair may involve the use of a graft if necessary to reconstruct the tendon.

Purpose

The procedure is aimed at fixing extensor tendon injuries in the leg, which can result in impaired movement and function. The primary goal is to restore the leg’s ability to extend and improve overall limb function and mobility.

Indications

• Pain and difficulty in extending the foot or toes.
• Visible deformity or trauma to the leg.
• Partial or complete tear of the extensor tendon.
• Previous unsuccessful conservative treatments.

Preparation

• Preoperative fasting as instructed by the surgeon, usually starting midnight before the procedure.
• Adjustments to current medications, particularly blood thinners.
• Pre-surgical evaluation including blood tests, imaging studies, and a physical examination.
• Arrangements for someone to drive the patient home post-surgery.

Procedure Description

1. Anesthesia: The patient is given regional or general anesthesia to numb the surgical area or induce sleep.
2. Incision: A precise incision is made over the site of the damaged tendon.
3. Exposure: The surgeon gently exposes the torn tendon.
4. Repair: The damaged ends of the tendon are stitched back together. If a graft is needed, it may be taken from another tendon in the body or a donor.
5. Closing: The incision is closed with sutures, and the leg is usually placed in a splint or cast.

Duration

The procedure typically lasts 90 minutes to 2 hours, depending on the complexity and the need for a graft.

Setting

The surgery is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurse
• Operating room technician

Risks and Complications

• Infection at the incision site.
• Bleeding or hematoma.
• Nerve damage causing numbness or weakness.
• Scarring and stiffness.
• Blood clots.
• Failure of the tendon to heal properly.

Benefits

• Restoration of leg and foot function.
• Reduced pain and discomfort.
• Increased mobility and strength.
• Enhanced quality of life and ability to perform daily activities.

Recovery

• Keep the leg elevated and apply ice to reduce swelling.
• Follow prescribed pain management plans, which usually include medications.
• Wearing a splint or cast for several weeks.
• Physical therapy to regain strength and flexibility.
• Follow-up appointments with the surgeon to monitor healing.
• Full recovery may take several months, with a gradual return to normal activities.

Alternatives

• Non-surgical treatments such as physical therapy, braces, or orthotics.
• Platelet-rich plasma (PRP) injections or stem cell therapy.
• Pros and cons of alternatives: Non-surgical methods may take longer and might not fully restore function. PRP and stem cell therapies are less invasive but have varying success rates.

Patient Experience

• During the procedure: The patient will be under anesthesia, so they will not feel pain.
• After the procedure: The patient may experience pain, swelling, and discomfort, which can be managed with prescribed pain medication and rest.
• Pain levels should gradually decrease, and regular follow-ups with the healthcare team ensure proper healing and progress.