CPT® Code 26433

The procedure described by CPT® Code 26433 involves the repair of the extensor tendon at its distal insertion, specifically addressing injuries that can lead to conditions such as mallet finger. Mallet finger is characterized by a flexion deformity of the distal interphalangeal joint, resulting in the inability to straighten the affected finger. This injury typically occurs due to a blunt force trauma to the fingertip, which can cause the tendon to tear or rupture. In some instances, the injury may also involve an avulsion fracture, where a fragment of bone is pulled away along with the tendon. The repair can be classified as either primary or secondary; primary repair is generally performed within 24 hours of the injury, while secondary repair is indicated for cases where the repair is conducted more than two weeks post-injury. The surgical approach involves exposing the tendon through a dorsal incision, with careful dissection of the surrounding soft tissues to protect vital neurovascular structures. The surgeon locates the distal and proximal ends of the ruptured tendon, which may necessitate an additional incision for proper access. The repair process involves approximating and suturing the tendon ends together, and if there is an associated bone fragment, it may be secured to the distal phalanx using a pin or screw. This procedure is crucial for restoring function to the finger and is reported for each flexor tendon that is repaired.