# MP contracture release, tenolysis, EDC and EDQP



## Justarose (Jun 17, 2009)

oh my ... I felt a song coming on ..that is how crazy I am becoming 

I need your advice and tell me if I am seeing it correctly please 

POSTOPERATIVE DIAGNOSIS:	Contracture, MP joint, right fifth finger.   718.44 

PROCEDURE PERFORMED:	MP contracture release 26520 RT   ;
 tenolysis, EDC and EDQP.   26440 RT ( not sure about the F modifiers or not) 

ANESTHESIA:	General.

PERIOPERATIVE ANTIBIOTICS:	None.

COMPLICATIONS:	None.

INDICATIONS FOR THE PROCEDURE:   a 41-year-old gentleman who had a previous fracture, developed a contracture of the MP joint, had subsequently recurred.  He has lost motion, has deformity.  Secondary to deformity and loss of motion, he is requesting to proceed with surgery.  Understanding risks and benefits of surgical and nonsurgical treatment and possibility of additional surgery, neurovascular injury, infection, pain, deformity, and recurrence, he was willing to proceed. 

BRIEF DESCRIPTION OF PROCEDURE:  Consent was obtained.  The patient was taken to the operating room and was given a general anesthetic.  The right upper extremity was sterilely prepped and draped in normal fashion with DuraPrep.  The digit was blocked (can I bill the 20600 for this ? )with 0.5% Marcaine for postoperative pain control.  A longitudinal incision was made over the dorsal first webspace.  Cutaneous flaps were developed.  The EDC to the fifth finger and the EDQP were significantly scarred to the metacarpal neck at the area of the previous fracture.  This was released.  The capsule was excised completely over the dorsal wrist.  We recessed the collateral ligaments; and once recessed, we were able to fully flex the MP joint without significant rebound.  The metacarpal head had reasonable cartilage.  The proximal phalanx had reasonable cartilage and only minimal arthritic changes from the previous fracture.  At this point, the tendons were noted to glide nicely after release of the tendons proximally into the hand and excision of all scar.  The EDQP was sewn to the EDC to the fifth finger with 3-0 Ethibond and then the MP hyperflexed.  This demonstrated an intact repair.  We then closed the skin with a 4-0 Prolene.  A dry dressing and splint were applied with the MP in full flexion.  The patient was transferred to the recovery room in stable condition. 

thank you


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## ojonse (Jan 8, 2010)

Is this correct??

thanks


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