Name of the Procedure:

Repair, tendon, extensor, foot; primary or secondary, each tendon

Summary

This procedure involves the surgical repair of a damaged extensor tendon in the foot. The extensor tendons are responsible for extending the foot and toes, and this repair can be done as a primary surgery (initial repair) or secondary (following a previous surgery or injury).

Purpose

The procedure aims to restore function and movement to the foot and toes by repairing a torn or injured extensor tendon. It is particularly concerned with alleviating pain, improving mobility, and preventing further tendon damage.

Indications

• Inability to extend the foot or toes
• Significant pain or swelling in the tendon area
• Partial or complete tendon tear
• Persistent discomfort despite conservative treatments
• Functional impairment affecting daily activities

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to current medications, such as blood thinners, may be required.
• Diagnostic tests like MRI or ultrasound may be conducted to assess the extent of tendon damage.

Procedure Description

1. The patient is given appropriate anesthesia, which could be local or general, depending on the case.
2. An incision is made over the injured tendon.
3. The surgeon identifies the damaged tendon and cleans the area.
4. The tendon ends are carefully stitched together or reinforced using graft tissue, if necessary.
5. The incision is closed with sutures, and the foot is bandaged or placed in a cast.
6. The patient is monitored during the immediate post-operative period.

Duration

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

Setting

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

Personnel

• Orthopedic surgeon or podiatric surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and technicians

Risks and Complications

• Infection at the surgical site
• Tendon re-rupture
• Nerve damage causing numbness or tingling
• Prolonged swelling or stiffness
• Delayed healing

Benefits

• Restoration of foot and toe function
• Reduction in pain and discomfort
• Improved mobility and quality of life
• Decreased risk of further tendon damage

Recovery

• Post-procedure care includes keeping the foot elevated to reduce swelling.
• The use of crutches or a walker to avoid weight-bearing on the affected foot.
• Physical therapy may be recommended to regain strength and range of motion.
• Recovery time varies but typically ranges from 6 to 12 weeks.
• Follow-up appointments are necessary to monitor progress.

Alternatives

• Non-surgical treatments like physical therapy, orthotics, or pain management.
• Pros include avoiding surgery and associated risks; cons include the possibility of persistent symptoms and impaired functionality.
• Tendon transfer or other tendon surgeries may be considered for complex cases.

Patient Experience

• Patients may experience some pain and swelling, which can be managed with prescribed pain medications.
• Awkwardness or discomfort while navigating with crutches or a walker initially.
• Physical therapy sessions will focus on gradually restoring movement and strength to the foot and ankle area.
• Comfort measures include icing the surgical site and adhering to post-operative care guidelines.