SURGEON:
ASSISTANT SURGEON:
None.
ASSISTANT:
ANESTHESIA:
General.
PREOPERATIVE DIAGNOSIS(ES):
Right residual Haglund deformity at the medial aspect of the
Achilles tendon insertion.
POSTOPERATIVE DIAGNOSIS(ES):
Right residual Haglund deformity at the medial aspect of the
Achilles tendon insertion.
PROCEDURE:
Right Achilles debridement with secondary repair of Achilles
tendon with partial excision of calcaneal bone. CPT code is
27654.
OPERATIVE FINDINGS:
Residual Achilles tendinosis and exostosis of calcaneus.
SPECIMENS:
None.
FLUIDS:
250 mL of lactated Ringer's.
ESTIMATED BLOOD LOSS:
Minimal.
DRAINS:
None.
PATIENT CONDITION:
Stable.
TOURNIQUET TIME:
Approximately 30 minutes for right lower extremity.
OPERATIVE INDICATIONS:
A 58-year-old female, status post Haglund's resection,
debridement, and secondary repair with resolution in majority of
symptoms that continued pain localized to the most medial aspect
of the Achilles tendon, symptomatic, unresponsive to conservative
management affecting daily function.
OPERATIVE NOTE:
After operative consents had been obtained, the patient was taken
to the operative suite, placed in supine position. General
anesthetic was induced. IV antibiotic was infused. Official
time-out performed to identify both patient and involved
extremity. After the leg was prepped and draped in a standard
sterile fashion, the medial aspect of the Achilles tendon was
identified. A 1-inch incision was made, centered over the area
of patient's symptoms. Careful dissection through subcu,
hemostasis being maintained. The medial border of the Achilles
tendon was identified. It was found to be thickened, debridement
of the Achilles tendon was completed. Once we had debrided and
released a portion of the Achilles tendon off of the calcaneus, a
small excision of calcaneal exostosis was completed with a
rongeur. The wound was irrigated and then the Achilles tendon
was secondarily repaired with 2-0 FiberWire in an interrupted
fashion. Excellent repair was achieved. Wound was irrigated and
closed in routine fashion with 3-0 Vicryl for subcutaneous layer
and then 3-0 nylon on the skin. 10 mL of 0.25% Marcaine with
epinephrine was instilled around the incision. Sterile dressing
was applied. Posterior splint was applied. The patient was
awoken and taken to the recovery room in stable, satisfactory
condition. All counts were correct.
ASSISTANT SURGEON:
None.
ASSISTANT:
ANESTHESIA:
General.
PREOPERATIVE DIAGNOSIS(ES):
Right residual Haglund deformity at the medial aspect of the
Achilles tendon insertion.
POSTOPERATIVE DIAGNOSIS(ES):
Right residual Haglund deformity at the medial aspect of the
Achilles tendon insertion.
PROCEDURE:
Right Achilles debridement with secondary repair of Achilles
tendon with partial excision of calcaneal bone. CPT code is
27654.
OPERATIVE FINDINGS:
Residual Achilles tendinosis and exostosis of calcaneus.
SPECIMENS:
None.
FLUIDS:
250 mL of lactated Ringer's.
ESTIMATED BLOOD LOSS:
Minimal.
DRAINS:
None.
PATIENT CONDITION:
Stable.
TOURNIQUET TIME:
Approximately 30 minutes for right lower extremity.
OPERATIVE INDICATIONS:
A 58-year-old female, status post Haglund's resection,
debridement, and secondary repair with resolution in majority of
symptoms that continued pain localized to the most medial aspect
of the Achilles tendon, symptomatic, unresponsive to conservative
management affecting daily function.
OPERATIVE NOTE:
After operative consents had been obtained, the patient was taken
to the operative suite, placed in supine position. General
anesthetic was induced. IV antibiotic was infused. Official
time-out performed to identify both patient and involved
extremity. After the leg was prepped and draped in a standard
sterile fashion, the medial aspect of the Achilles tendon was
identified. A 1-inch incision was made, centered over the area
of patient's symptoms. Careful dissection through subcu,
hemostasis being maintained. The medial border of the Achilles
tendon was identified. It was found to be thickened, debridement
of the Achilles tendon was completed. Once we had debrided and
released a portion of the Achilles tendon off of the calcaneus, a
small excision of calcaneal exostosis was completed with a
rongeur. The wound was irrigated and then the Achilles tendon
was secondarily repaired with 2-0 FiberWire in an interrupted
fashion. Excellent repair was achieved. Wound was irrigated and
closed in routine fashion with 3-0 Vicryl for subcutaneous layer
and then 3-0 nylon on the skin. 10 mL of 0.25% Marcaine with
epinephrine was instilled around the incision. Sterile dressing
was applied. Posterior splint was applied. The patient was
awoken and taken to the recovery room in stable, satisfactory
condition. All counts were correct.