CPT® Code 26418

Injuries to the extensor tendons of the fingers can manifest as partial or complete lacerations, tears, or ruptures. These injuries often necessitate surgical intervention to restore function and mobility to the affected finger. The procedure described by CPT® Code 26418 involves the repair of the extensor tendon in the finger, which can be categorized as either a primary or secondary repair. A primary repair is typically performed within 24 hours following the injury, allowing for optimal healing conditions. However, in cases where the wound is grossly contaminated, the primary repair may be postponed for up to two weeks to ensure a cleaner surgical environment. Conversely, a secondary repair is defined as a surgical intervention that occurs more than two weeks after the initial injury, often due to complications or delayed presentation. The surgical approach for this procedure involves making a dorsal incision to expose the tendon, followed by careful dissection of the surrounding soft tissues while protecting the neurovascular structures. The surgeon locates the distal and proximal ends of the severed tendon, which may require an additional incision if the proximal end has retracted beyond the reach of the initial incision. Once located, the ends of the tendon are approximated and sutured together, effectively restoring the continuity of the tendon. This procedure is reported for each tendon that is repaired, emphasizing the meticulous nature of tendon repair in the context of hand surgery.