CPT® Code 26541

Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)

Reconstruction of the collateral ligament of the metacarpophalangeal (MCP) joint, as described by CPT® Code 26541, is a surgical procedure aimed at repairing damage to the ligament that stabilizes the joint between the metacarpal bone and the proximal phalanx of the finger. This procedure is typically indicated following traumatic injuries, such as lacerations or ruptures, which can compromise the integrity and function of the MCP joint. The collateral ligament plays a crucial role in maintaining joint stability during hand movements, particularly in gripping and pinching actions. In cases where an open wound is present, the surgical approach involves exploring the wound, removing any devitalized tissue, and clearing away foreign materials to ensure a clean surgical field. For closed injuries, a volar incision is made over the affected MCP joint to access the underlying structures. The procedure includes careful dissection of the subcutaneous tissue and fascia, with particular attention to protecting the neurovascular bundles that supply the hand. Once the injured collateral ligament is exposed, the extent of the injury is assessed, and a tendon or fascial graft is utilized to reconstruct the ligament. Commonly harvested grafts include the palmaris longus tendon, although other tendons may also be used. The graft is meticulously attached to the remaining ligament or bony structures, ensuring proper tension and range of motion before the surgical site is closed in layers. This procedure is essential for restoring function and stability to the MCP joint following significant ligamentous injury.