64831 Suture of digital nerve, hand or foot; 1 nerve

Name of the Procedure:

Suture of Digital Nerve, Hand or Foot; 1 Nerve

Summary

This procedure involves repairing a damaged nerve in the hand or foot through suturing. It aims to restore nerve function, sensation, and movement to the affected digit.

Purpose

The procedure addresses lacerations or injuries to the digital nerves in the hand or foot. Its goal is to repair the nerve to restore normal function and sensation, prevent long-term complications like numbness and impaired movement, and improve the quality of life.

Indications

• Loss of sensation in a finger or toe following an injury
• Traumatic laceration to the digital nerve
• Neuroma (painful nerve growth) formation
• Decreased motor function in the affected digit

Preparation

• Pre-operative fasting if general anesthesia is used.
• Adjustment of medications if required, especially blood thinners.
• Diagnostic tests such as nerve conduction studies or imaging to assess the extent of the injury.

Procedure Description

1. Local or general anesthesia is administered.
2. The surgeon makes an incision to expose the damaged nerve.
3. The injured nerve ends are carefully aligned and sutured together using microsurgical techniques.
4. The incision is then closed with sutures, and the area is bandaged.

Tools used include:

• Microsurgical instruments like precision scissors and forceps
• Fine sutures specifically designed for nerve repair
• Microscopes to enhance the precision of the repair

Duration

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

Setting

The procedure is usually performed in a hospital or an outpatient surgical center.

Personnel

• Hand or foot surgeon (often a plastic or orthopedic surgeon)
• Surgical nurse
• Anesthesiologist
• Operating room technician

Risks and Complications

• Infection at the surgical site
• Nerve damage or incomplete nerve recovery
• Scarring
• Prolonged numbness or tingling
• Reduced range of motion

Benefits

• Restoration of sensation and motor function
• Prevention of chronic pain and neuroma formation
• Improved hand or foot function and quality of life

Recovery

• Keep the hand or foot elevated to reduce swelling.
• Pain management through prescribed medications.
• Physical therapy may be recommended to restore function.
• Avoid strenuous activities for several weeks.
• Follow-up appointments to monitor the healing process.

Alternatives

• Non-surgical management with physical therapy and adaptive techniques.
• Nerve grafting or nerve transfer in cases where direct suturing is not feasible.
• The choice of treatment depends on the severity and location of the nerve injury, each with its own pros and cons concerning recovery time and effectiveness.

Patient Experience

During the procedure, the patient will be under anesthesia and should not feel pain. Post-procedure, patients might experience discomfort, swelling, and temporary numbness, which can be managed with medications and rest. Full sensation and function recovery may take several weeks to months, depending on the extent of the nerve injury and the individual’s healing process.