CPT® Code 29902

Surgical arthroscopy of the metacarpophalangeal joint involves a minimally invasive procedure aimed at addressing injuries to the ulnar collateral ligament (UCL), which is crucial for the stability of the thumb. The UCL can sustain injuries that manifest as either avulsion fractures or tears, particularly at its insertion point on the proximal phalanx. A specific type of injury known as a Stener lesion occurs when the UCL is avulsed and the aponeurosis of the thumb adductor interposes itself between the avulsed ligament and its original attachment site. This condition is commonly associated with activities that put stress on the thumb, such as skiing or gripping, leading to what is often referred to as skier's thumb or gamekeeper's thumb. The procedure begins with the application of a finger trap to facilitate traction on the thumb, followed by the creation of portal incisions to access the metacarpophalangeal joint. Through these portals, the surgeon can perform a thorough inspection of the joint, remove any obstructive debris, and ultimately reduce the displaced UCL back to its anatomical position, ensuring proper healing and restoration of thumb function.