64890 Can I use 64831 Also???
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His previous sutures were removed, and the incision was opened. Additional axial extensions were made to provide for additional visualization. Subcutaneous flaps were made, and in injury inventory was made. The flexor digitorum superficialis tendon had a 60% laceration on the radial slip, but the ulnar slip was 100% intact. The flexor digitorum profundus tendon had a 10% laceration. The ulnar digital nerve was completely intact. There was complete laceration of the radial digital nerve and artery with significant contusion proximally and distally. Decision was made to proceed with reversed interposition nerve graft. An incision was made in the forearm at the radial border of the brachioradialis muscle, and subcutaneous dissection was undertaken. The cephalic vein was identified, and 2 branches of the lateral brachial cutaneous nerve were identified. The nerve was mobilized for a distance of approximately 3 cm. It was then transected proximally and distally, and marked so that it could be reversed for interposition grafting. This incision was closed using 4-0 Monocryl deep dermal plane, and running 4-0 Monocryl subcuticular. Attention was then turned to the hand. Contused segments of the proximal and distal portion of the radial digital nerve were identified, and the interposition nerve graft was placed. The nerve history of sharply using microsurgical technique proximally and distally, and the interposition graft was sewn in in a reversed fashion using 9-0 nylon interrupted sutures.
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His previous sutures were removed, and the incision was opened. Additional axial extensions were made to provide for additional visualization. Subcutaneous flaps were made, and in injury inventory was made. The flexor digitorum superficialis tendon had a 60% laceration on the radial slip, but the ulnar slip was 100% intact. The flexor digitorum profundus tendon had a 10% laceration. The ulnar digital nerve was completely intact. There was complete laceration of the radial digital nerve and artery with significant contusion proximally and distally. Decision was made to proceed with reversed interposition nerve graft. An incision was made in the forearm at the radial border of the brachioradialis muscle, and subcutaneous dissection was undertaken. The cephalic vein was identified, and 2 branches of the lateral brachial cutaneous nerve were identified. The nerve was mobilized for a distance of approximately 3 cm. It was then transected proximally and distally, and marked so that it could be reversed for interposition grafting. This incision was closed using 4-0 Monocryl deep dermal plane, and running 4-0 Monocryl subcuticular. Attention was then turned to the hand. Contused segments of the proximal and distal portion of the radial digital nerve were identified, and the interposition nerve graft was placed. The nerve history of sharply using microsurgical technique proximally and distally, and the interposition graft was sewn in in a reversed fashion using 9-0 nylon interrupted sutures.
