CPT® Code 25312

Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendon

Tendon transplantation or transfer of a single flexor or extensor tendon at the forearm or wrist is a surgical procedure aimed at restoring function that may have been compromised due to various conditions. This procedure is typically indicated following traumatic injuries affecting the nerve, tendon, or muscle, which can lead to significant loss of function. In some cases, the loss of function may also arise from chronic conditions such as rheumatoid arthritis or gouty arthritis. The specific approach taken during the procedure can vary based on the particular function that the surgeon aims to restore. For instance, if the patient is experiencing compromised finger flexion, the surgeon may opt to transfer the flexor carpi ulnaris tendon or the flexor carpi radialis tendon. Conversely, if the goal is to restore extension of the fingers, the extensor carpi radialis tendon may be transferred. The surgical technique involves making a longitudinal incision over the donor tendon to expose it, followed by careful dissection to free the tendon from its attachments, allowing it to be secured to the recipient site. This may involve harvesting the tendon along with a strip of periosteum to ensure adequate length and stability. Additionally, the muscle associated with the donor tendon is released from fascial attachments to maximize its mobility. A second incision is then made at the recipient site where the tendon will be attached. The donor tendon is routed to this site and temporarily secured with sutures. To ensure proper function, a neuromuscular stimulator is utilized to test the donor tendon, and adjustments are made to its tension as necessary before it is permanently secured. After the surgical wounds are closed, immobilization of the wrist and/or hand is performed as needed to facilitate recovery.