CPT® Code 26426

Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); using local tissue(s), including lateral band(s), each finger

The procedure described by CPT® Code 26426 involves the repair of the extensor tendon, specifically the central slip, which is a critical component in the function of the fingers. The extensor tendons are responsible for the extension of the fingers, allowing them to straighten. The central slip is a specific part of the extensor tendon that attaches to the middle phalanx of the finger. When this slip is damaged, it can lead to a condition known as boutonniere deformity, characterized by the inability to fully extend the finger at the proximal interphalangeal joint. This injury can occur due to various reasons, including a direct impact to a bent finger, a laceration that severs the tendon, or conditions such as rheumatoid arthritis. The repair procedure classified under this code is considered a secondary repair, which means it is performed after a primary repair has failed or after a significant delay following the initial injury. The surgical approach involves making an incision over the top of the finger to access the extensor tendon and central slip. The repair techniques may vary based on the specific nature of the injury, but they typically involve the rearrangement of local tissues, including the lateral bands of the tendon. This may include repositioning the lateral bands to stabilize the joint or using one lateral band to reconstruct the central slip while elongating the opposite band. Additionally, a Kirschner wire is often utilized to maintain the proximal interphalangeal joint in an extended position during the healing process. This procedure is essential for restoring the function of the finger and preventing long-term complications associated with tendon injuries.