# Ulnar shortening



## VioletP (Oct 26, 2012)

Not sure which code to use CPT 25360 or 25390 any help would be appreciated.


_  The subcutaneous border of the ulna was identified and periosteum stripped palmarly.  The Rayhack ulnar shortening osteotomy system was used.  The guide was placed on the  volar surface of the ulna and secured by sequentially placing screws #2, #4, and #3.  The  saw was used with copious irrigation to make a 3.5-mm shortening, using  the  2  proximal  slots, which were closest together.  The saw guide was then removed.   The  plate  was  slightly  contoured and secured with a screw in the  #2  position.   The  compression  guide was then applied using #3 and #4 screws, both about 4  mm  longer  than  originally  measured.  The osteotomy was gently closed.  The oblique  cutting  guide was placed and a 2.7-mm hole drilled through the near cortex.  The top hat was  placed  and  a  2  mm  hole drill to the far cortex of the  ulna.   The  length  was  measured, the hole was tapped and a 2.7 mm lag screw placed.  The #5 screw was  then  placed followed by locking screws at either end of the plate.  The compression guide  was  removed in the appropriate length 3 and 4 screws were then replaced.  The image  intensifier  was  brought into the field to verify the length of the  screws,  which  were  appropriately  adjusted.   The osteotomy  was  barely  visible  on  the  image  intensifier  and  was  very  well approximated when  visualized.   The  wounds  were  copiously  irrigated.   A tip of the bone taken from around  the  drill  holes,  was  packed  around  the  osteotomy site.  The fascia was closed with  running  4-0  PDS,  subcutaneous  tissue  was closed with PDS, and the skin with a running  subcuticular  Monocryl suture.  Sterile dressings and a short-arm splint were applied._


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## akrug (Oct 26, 2012)

25390


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## VioletP (Oct 30, 2012)

Thank you. I was leaning towards that one


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