# HELP- Hardware exchange Hip -



## rprejean (May 6, 2010)

HELP - completely stumpted - I can't find anything, would I just use unlisted procedure 27299 with symptomatic hardware Dx996.78
ANY recommendations Greatly appreciated!

PREOPERATIVE DIAGNOSIS:  Hardware migration, left hip.

PROCEDURE:  Hardware exchange left hip.

PROCEDURE IN DETAIL:  General anesthesia was induced.  The patient was gently placed on the fracture table.  The C arm was used to monitor the case.  This patient had previously received a TFN for a base of the neck left hip fracture.  The fracture settled the triflanged nail migrated to the articular
surface.  The purpose of this procedure was to remove the triflange nail and
insert a shorter nail into the femoral head and neck region.  On the fracture
table the left hip and leg were prepped and draped sterilely.  The previous
distal incision was opened.  The triflange nail was localized.  A guide pin
was placed.  The extractor device was then inserted and attached.  Proximally, the incision was opened.  The soft tissue was dissected in order to insert a screwdriver to loosen the set screw.  Once this was done the triflange nail was removed.  Previously we had used 100 millimeter nail and now we placed a 85 millimeter nail.  It was impacted over a guide pin and stopped well short of the articular surface as viewed with AP and lateral images.  Bleeding was minimal.  Both wounds were copiously irrigated.  The soft tissue was closed with Vicryl and the skin with staples.  Sterile dressings completed the procedure.














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