CPT® Code 26260

1. Indications

The radical resection of a tumor in the proximal or middle phalanx of the finger is indicated for the following conditions:

• Malignant Neoplasm The primary indication for this procedure is the presence of a malignant tumor in the proximal or middle phalanx of the finger, necessitating complete removal to prevent further spread of cancer.
• Benign Tumors In some cases, benign tumors that may cause significant symptoms or complications may also require radical resection.
• Indeterminate Tumors Tumors of indeterminate nature, where the potential for malignancy is uncertain, may also warrant this aggressive surgical approach to ensure comprehensive evaluation and treatment.

2. Procedure

The procedure for radical resection of a tumor in the proximal or middle phalanx of the finger involves several critical steps:

• Step 1: Incision A skin incision is made directly over the site of the bone tumor located in the proximal or middle phalanx. In certain cases, a skin flap may be created and elevated to enhance access to the tumor.
• Step 2: Dissection The surgeon carefully dissects the overlying tissue to expose the tumor. This step is crucial to ensure that the tumor is adequately visualized and that surrounding tissues are preserved as much as possible.
• Step 3: Tumor Resection All bone and cartilage that show signs of tumor involvement are resected. The tumor is removed en bloc, which means it is excised along with a wide margin of surrounding healthy tissue to ensure complete removal of any malignant cells.
• Step 4: Soft Tissue Excision The procedure includes the excision of all involved soft tissue, which may consist of muscles, tendons, fat, blood vessels, lymph vessels, nerves, and any tissues surrounding the joints, to ensure that no cancerous cells remain.
• Step 5: Frozen Section A separately reportable frozen section may be performed during the procedure to confirm that all margins are free of tumor cells. If any margins are found to contain malignancy, additional tissue will be excised until clear margins are achieved.
• Step 6: Drain Placement Drains may be placed as needed to prevent fluid accumulation at the surgical site, which can aid in the healing process.
• Step 7: Wound Closure The surgical wound may be closed in layers, or if necessary, separately reportable reconstructive procedures may be performed to restore the appearance and function of the finger.

3. Post-Procedure

After the radical resection procedure, patients can expect a recovery period that may involve monitoring for complications such as infection or excessive swelling. The surgical site will require proper care to promote healing, and follow-up appointments will be necessary to assess recovery and ensure that all margins remain clear of malignancy. Pain management and rehabilitation may also be part of the post-procedure care to restore function and mobility in the affected finger.