Tenotomy, percutaneous, toe; multiple tendons
CPT4 code
Name of the Procedure:
Tenotomy, Percutaneous, Toe; Multiple Tendons
Summary
Tenotomy is a minimally invasive surgical procedure where small incisions are made to cut one or more tendons in the toe. This helps to release tight tendons and correct deformities. The procedure uses a needle or a small blade to precisely sever the tendons.
Purpose
Medical Condition or Problem Addressed
To correct deformities such as claw toe, hammer toe, or other contractures caused by tight or shortened tendons.
Goals or Expected Outcomes
The goal is to relieve pain, improve the alignment and function of the toe, and restore normal walking ability.
Indications
Symptoms or Conditions
- Claw toe or hammer toe deformities
- Toe contractures causing pain or discomfort
- Difficulty wearing shoes or walking due to toe position
Patient Criteria
- Non-responsive to conservative treatments such as orthotics or physical therapy
- Persistent pain or functional impairment
Preparation
Patient Instructions
- Fasting may be required if general anesthesia is used
- Adjustments to medications, particularly blood thinners, as advised by the healthcare provider
- Diagnostic imaging to assess the severity of tendon contracture
Procedure Description
Step-by-Step Explanation
- The patient is positioned comfortably, and the toe is sterilized.
- Local anesthesia is administered to numb the area.
- Using a small needle or blade, the surgeon makes tiny incisions to access the affected tendons.
- The tendons are severed or released to relax the toe.
- The incisions are closed with minimal or no suturing, and a bandage is applied.
Tools/Technology Used
- Needle or small surgical blade
- Sterilization tools
- Local anesthesia
Anesthesia Details
Typically performed under local anesthesia; however, may require general anesthesia in specific cases.
Duration
The procedure typically takes about 15-30 minutes, depending on the number of tendons involved.
Setting
Usually performed in an outpatient clinic or surgical center.
Personnel
- Orthopedic or podiatric surgeon
- Nursing staff
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
Common Risks
- Infection
- Bleeding
- Swelling
Rare Risks
- Nerve damage
- Persistent pain or recurring deformity
- Scarring
Management
Proper wound care and follow-up visits to manage any complications.
Benefits
Expected Benefits
- Relief from pain
- Improved toe alignment and function
- Enhanced mobility
Realization of Benefits
Benefits are typically realized within a few weeks after the procedure, although full recovery may vary.
Recovery
Post-Procedure Care
- Keep the incision area clean and dry
- Follow wound care instructions provided by the healthcare provider
- Gradual return to normal activities as advised
Recovery Time
- Initial recovery in a few days; full recovery may take several weeks
- Possible use of protective footwear during recovery
Follow-up Appointments
Scheduled follow-up appointments to monitor healing and progress.
Alternatives
Treatment Options
- Physical therapy
- Orthotic devices
- Non-surgical toe straightening techniques
Pros and Cons of Alternatives
- Less invasive but may not be as effective for severe deformities
- Longer duration of treatment and possible lower success rates compared to surgery
Patient Experience
During Procedure
- Minimal discomfort due to local anesthesia
- Sensation of pressure or movement but not pain
After Procedure
- Mild pain or soreness managed with over-the-counter pain relief
- Instructions on pain management and activity restrictions for comfort
By understanding these aspects, patients can make informed decisions regarding their treatment options and have realistic expectations about the procedure and recovery process.