# ORIF with revision of left femoral prosthesis



## efuhrmann (Sep 29, 2009)

How would I code:
pt underwent a left total hip arthroplasty and 3 days later fell, sustaining a left femoral periprosthetic fracture?
The previous incision was utilized and then extended.  This was carried down through the subq tissues.  All sutures encountered were removed.  The same cleft in the fascia lata was utilized, going through all the sutures.  This then was carried down 10 cm distally.  The sutures were taken down and out of the fascia, and the dascial incision was carried down distally for the extent of the incision.  The sutures from the piriformis had pulled out and these were removed-the same as with the capsule.  The hip was dislocated and the femoral neck exposed.  The previous component was stuck in the femoral canal.  The head was removed and then the prosthese in its entirety.  An incision was made in the vastus lateralis, starting at the very superior aspect an carrying it down adjacent to the posterolateral portion of the femur.  The muscle was carefully elevated up as one.  There was a large posteromedial fragment that appeared to have fractured off in a v-shaped fracture.  The fracture was irrigated.  Then the fracture was reduced and held in place with a single cerciage wire.  Then a 160-mm trochanteric plate was applied with the sharp edges impacted into the trochanter.  This was held in place with three more cerclage cables.  Attention was turned to the proximal femur.  The femur was prepared using a cylindrical reamer that fit the #11 restoration stem.  Once the proximal femur was prepared the #11 stem was impacted ensuring a good fit.  Once this had been reduced, trial heads were utilized.  The 5-36-mm head gave good stability. Then the C-arm was utilized...
please respond someone out there


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## Lisa Bledsoe (Sep 30, 2009)

What about 27134-78 / 996.44; 27244-78-51 / 820.20 or 820.22?


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## efuhrmann (Sep 30, 2009)

thanks Lisa.


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