# Closed reduction and percutaneous pinning with accumed mini screw



## RaquelBorja (Jan 12, 2011)

Our hand surgeon performed closed reduction and percutaneous pinning with Accumed mini screw size 18 and wants me to code it as 25999 comparable to 25606 along with 25628 for screw scaphoid through small incision??

This is what the operative report indicates:  Attention was drawn to placing the 0.045 K-wire from the proximal pole of the scaphoid to the distal end through the trapezial bone.  AP lateral viewes were obtained all the time in the flex position of the wrist, as well as pronation and ulnar deviation.  After excellent position of the k-wire was achived, a second k-wire was placed to prevent derotation through the length of the scaphoid on the radial side.  Next attention was drawn to making a small incision at the proximal pole dorsally of the scaphoid about 4mm long with a mosquito.  The soft tissue was free from the surrounding k-wire and after that a special design short drill from Acumed about 1.5 cm was used to make entry into the scaphoid bone, and after that a small drill was used to about 3mm close to the distal end of the scaphoid and a hole for the screw was drilled.  THe length of the screw was 22mm, a 4mm length last was used.  An 18mm screw was placed inside the scaphoid and excellent purchase and very good position of the screw was achieved.  At this point the kwires were removed, one to use as a derotational and another one for the placement of the screw.  AP lateral and PA views showed excellent position of the screw.


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