CPT® Code 24331

1. Indications

Flexor-plasty of the elbow, as described by CPT® Code 24331, is indicated for the following conditions:

• Complete or Partial Detachment of the Flexor-Pronator Complex This procedure is performed when there is a significant detachment of the flexor-pronator complex at the elbow, which may lead to functional impairment.
• Improvement of Elbow Flexion The surgery is also indicated for patients who require enhancement of flexion capabilities at the elbow joint, particularly when conservative treatments have failed.

2. Procedure

The procedure for flexor-plasty of the elbow under CPT® Code 24331 involves several detailed steps:

• Incision and Access An incision is made over the elbow joint to provide access to the flexor-pronator complex and surrounding structures. This initial step is crucial for visualizing the area and performing the necessary surgical interventions.
• Ulnar Nerve Dissection The ulnar nerve is carefully dissected and protected during the procedure to prevent any potential nerve damage, which is essential for maintaining hand and finger function post-surgery.
• Detachment of the Flexor-Pronator Complex If the flexor-pronator complex is intact, it is surgically detached along with a portion of the medial epicondyle using a chisel. This detachment is necessary to allow for the subsequent repositioning of the flexor group.
• Dissection of the Flexor Group The flexor group is then meticulously dissected to prepare it for transfer. This step involves careful handling to preserve the integrity of the muscle tissue.
• Drilling the Humerus A planned attachment site on the humerus is drilled to facilitate the reattachment of the flexor group. This drilling creates a secure point for fixation.
• Transfer and Attachment of the Flexor Group The freed flexor group is transferred proximally by 2-6 cm and attached to the medial or mediovolar surface of the humerus. This repositioning is critical for restoring function.
• Securing the Flexor Group A fixing wire is pulled through the drill hole to secure the flexor group in place. Additionally, screw fixation may be utilized to stabilize the epicondyle fragment, ensuring that the reattached structures remain secure during the healing process.
• Release and Advancement of the Lateral Extensor Group Following the flexor-plasty, the lateral extensor group is also released and transposed proximally by 3-7 cm. This step is performed to enhance the overall function of the elbow joint.
• Fixation of the Lateral Extensor Group The lateral extensor group is fixed to the humerus in the same manner as the flexor group, ensuring that both groups are properly aligned and secured for optimal recovery.

3. Post-Procedure

Post-procedure care following flexor-plasty of the elbow involves monitoring the surgical site for signs of infection and ensuring proper healing of the reattached structures. Patients may be advised to engage in physical therapy to regain strength and range of motion in the elbow joint. The recovery process may vary depending on the extent of the surgery and the individual patient's healing response. Regular follow-up appointments are essential to assess the progress and make any necessary adjustments to the rehabilitation plan.