# Periprosthetic femur fracture



## scooter1 (Jan 7, 2011)

this is a fracture around total hip replacement.
Incision made parallel w/proximal femur. Fracture site was identified very carefully around it's proximal medial and posterior lateral aspects. After removing firm clot from within the fracture site and manipulation of the thigh, the fx was anatomically reduced and held with bone clamps.  There was an additional longitudinal split, which is nondisplaced, extending 3 to 4 cm distal to the apex of the fx. reduction was achieved & held with bone clamps. Fx was further secured with double Luque wires x2. We placed a 6.5 inch Dall-Miles cable plate which spanned the length of the fx and extended well distal to provide additional support. Six cables were passed. Each bridge was crimped. Luque wires were left in place.   
I am unsure if I should use 27507 or possibly 27244?  Dr states to me that this was a rather involved procedure.   I would be so appreciative of suggestions. This is the first
periprosthetic fracture I have had. Thank you


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## maryanneheath (Jan 7, 2011)

wsr1614@yahoo.com said:


> this is a fracture around total hip replacement.
> Incision made parallel w/proximal femur. Fracture site was identified very carefully around it's proximal medial and posterior lateral aspects. After removing firm clot from within the fracture site and manipulation of the thigh, the fx was anatomically reduced and held with bone clamps.  There was an additional longitudinal split, which is nondisplaced, extending 3 to 4 cm distal to the apex of the fx. reduction was achieved & held with bone clamps. Fx was further secured with double Luque wires x2. We placed a 6.5 inch Dall-Miles cable plate which spanned the length of the fx and extended well distal to provide additional support. Six cables were passed. Each bridge was crimped. Luque wires were left in place.
> I am unsure if I should use 27507 or possibly 27244?  Dr states to me that this was a rather involved procedure.   I would be so appreciative of suggestions. This is the first
> periprosthetic fracture I have had. Thank you




I do not think that I would use 27507 as that is for open treatment of the femoral shaft, and the note states proximal femur.  Don't let the word periprosthetic throw you.  This is still a femur fracture.  I personally would lean toward 27244, but I would also code with my physician and give him the option of 27236 as well.


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## scooter1 (Jan 10, 2011)

Thank you for your help. I was leaning more towards the 27244 so it is great to get an affirmation.


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