CPT® Code 26185

Sesamoidectomy is a surgical procedure that involves the removal of sesamoid bones located in the thumb or finger. Sesamoid bones are small, round bones that are embedded within tendons and serve several important functions, including modifying pressure, reducing friction, and changing the direction of muscle pull. In the human hand, sesamoid bones are not universally present in all individuals, nor are they consistently located in the same areas. Typically, most individuals possess five sesamoid bones in each hand, with two situated in the metacarpophalangeal (MCP) joint of the thumb, one in the interphalangeal (IP) joint of the thumb, one at the MCP joint of the index finger, and one at the MCP joint of the little finger. Less frequently, sesamoid bones may also be found in the MCP joints of the middle and ring fingers, as well as at the distal IP joint of the index finger. The decision to perform a sesamoidectomy is often based on the specific sesamoid bone that requires excision, and the surgical approach is tailored accordingly. The procedure typically involves making an incision over the affected joint, carefully dissecting the overlying tissue while protecting the digital nerves, and inspecting the surrounding joint structures for any signs of injury or disease. The surgeon then locates the sesamoid bone within the tendon through palpation, incises the tendon longitudinally, and excises the sesamoid bone while preserving the tendon’s integrity. Finally, the incisions are closed, and a bulky dressing and splint are applied to support the area during the recovery process.