# Excision of distal pole of patella w/ repair



## laurabee (Apr 5, 2009)

I'm thinking 27424 or 27350 but I could very well be wrong. 

DX: Transverse patella fracture, comminuted, right knee

Operation: Excision, distal pole of patella, with advancement of patellar tendon to proximal pole, with patella repair

Knee was approached through a longitudinal incision. Dissection was sharp through the sin and sharp down to the extensor mechanism. Transverse fracture of the patella was identified. Hematoma was irrigated and evacuated and the proximal pole inspected. It was significantly comminuted through the articular surface and on the dorsal surface as well, and it was felt that it was not repairable. It was excised, and the knee copiously irrigated. All loose fragments were evacuated from the knee, and the patellar tendon was prepared for advancement. Three drill holes were placed in the patella longitudinally, and #2 Fiberwire was used to stitch the patellar tendon in a Kessler type fasion. Two sutures were placed and advanced through the patella, and with the knee in extension, sutured down. This pulled the patellar tendon right up to the fresh surface of the patella. Anteriorly, the remaining tendon and periosteum were repaired to bone with #2 Fiberwire sutures. The retinaculum medially and laterally was closed with #1 Vicryl.


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## skrupicki (Jul 2, 2009)

*Please Clarify*

I am looking at a ruptured patella tendon repair in which the Surgeon also lists the medial and lateral suture of the retinaculum. Is this included in the patella tendon repair?


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