# Percutaneous vs Open fixation femoral neck fracture



## Ccgerson (Sep 15, 2016)

Can someone please confirm if this is percutaneous fixation of the femoral neck - 27235?  Physician calls this ORIF femoral neck fx, but I don't see where he visualized the fracture.  The DHS and cannulated screws, fluoroscopy tell me it's percutaneous.  Am I correct?  Thank you!

A distal femoral traction pin was placed. The position of the traction pin was confirmed under biplanar fluoroscopy. The left lower extremity was then able to be positioned with the traction bow attachment for the fracture table. The fracture was then reduced using traction and rotation to the fracture table. The fracture reduction was confirmed under fluoroscopy. The left lower extremity was prepped and draped in a sterile fashion.
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An incision over the lateral femur was made with a #10 blade. Hemostasis was maintained with Bovie electrocautery. Dissection was carried down to the lateral femur, which was cleared with a Cobb elevator. The DHS aiming jig was positioned on the lateral femoral and the position was checked under fluoroscopy. The position of the jig was adjusted as necessary. The DHS) was then placed through the aiming jig into the femoral head under fluoroscopic guidance. Satisfied with the position of the DHS guide pin, a second guidepin for a Synthes 7.3 mm cannulated screw was then placed in a parallel trajectory under fluoroscopic guidance. The DHS guide pin was then measured, overdrilled, tapped, and the DHS lag screw was placed over the guidewire. The 2 hole DHS sideplate was then placed. The DHS shaft screws were then drilled, measured and placed. The cannulated screw guidepin was then measured, overdrilled and a Synthes 7.3 mm long threaded cannulated screw was placed. The guidewires were removed. Final position of the fracture and the hardware was verified under fluoroscopy and found to be satisfactory.

Cindy Gerson, CPC


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## Orthocoderpgu (Sep 15, 2016)

I think your ORIF. He states that  dissection was taken down to the femur and a cobb elevator was used to clear the area. The cobb elevator is a hand-held tool that was used. I think he's ORIF.


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