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Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)

CPT4 code

Name of the Procedure:

Lengthening or Shortening of Tendon, Leg or Ankle; Single Tendon (Separate Procedure)

Summary

This procedure involves either lengthening or shortening a tendon in the leg or ankle. Tendons are strong, fibrous tissue that connects muscle to bone, and adjusting their length can address various conditions affecting movement and flexibility.

Purpose

The procedure aims to correct issues related to tendon tightness or laxity which can impede movement or cause pain. It is often used to improve mobility, alleviate pain, and restore proper function to the affected limb.

Indications

This procedure is indicated for patients with conditions such as tendon contracture, muscle imbalances, certain types of deformities, or injuries that have resulted in abnormal tendon length. It is particularly suitable for individuals experiencing restricted movement, significant pain, or functional impairments due to these tendon issues.

Preparation

Patients may need to fast for a set period before the procedure and may be advised to adjust or stop specific medications. Diagnostic tests, such as X-rays or MRIs, could be required to assess the tendon and surrounding structures.

Procedure Description

  1. Anesthesia: The patient is given regional or general anesthesia.
  2. Incision: A small incision is made near the tendon.
  3. Adjustment: The tendon is carefully lengthened or shortened using surgical techniques.
  4. Closure: The incision is closed with sutures or staples, and a bandage is applied. Specialized surgical tools and possibly imaging technology assist in the precise alteration of the tendon.

Duration

The procedure typically takes 1 to 2 hours, depending on the specific tendon and complexity.

Setting

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

Personnel

The procedure involves a team including an orthopedic surgeon, an anesthesiologist, surgical nurses, and possibly a physical therapist for post-operative care.

Risks and Complications

  • Common Risks: Infection, bleeding, and scarring.
  • Rare Risks: Nerve damage, tendon rupture, or failure to achieve desired tendon length.
  • Management: Complications are managed with medications, physical therapy, or additional surgical interventions if necessary.

Benefits

The expected benefits include improved mobility, reduced pain, and enhanced overall function of the leg or ankle. These benefits are usually realized within a few weeks to months after the procedure and rehabilitation.

Recovery

Post-procedure care includes keeping the incision site clean and dry, using crutches or a walking boot if recommended, and attending physical therapy sessions. Full recovery can take several weeks to months, with restrictions on weight-bearing activities and follow-up appointments to monitor progress.

Alternatives

Alternative treatments may include physical therapy, orthotic devices, or less invasive surgical options. Each alternative has its own set of pros and cons which should be discussed with the healthcare provider, considering the patient's specific condition and needs.

Patient Experience

During the procedure, the patient will be under anesthesia, so they will not feel pain. Post-procedure, there may be some discomfort and swelling, which can be managed with prescribed pain medications and ice packs. Physical therapy and rest are crucial for recuperation and comfort.

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