kellit21
Guru
Hi can anyone help me with coding this surgery?
Operative Diagnosis:
1. Debridement of infamed tissue from within the peroneal tendon sheath, right ankle.
2. Repair of longitudal split tear of the peroneus longus tendon.
3. Debulking of the peroneus longus muscle distally in the groove.
4. Reefing and repair with augmentation of the peroneal retinaculum, right ankle.
A gently curved incision was made tracking the course of the distal peroneal tendond behind the fibula and then turning on to the foot. The peroneal retinaculum was uncovered and opened longitudinally leaving a flap attached to the distal fibula. The tendons were delivered and extensively debrided of tenosynovitic tissue. It was noted that the peroneus longus muscle extended much rather distally than its usual really passed the tip of the distal fibula. There was also an accessory tendon associated with that muscle tissue. This material was debrided away. There was a fusiform enlargement in the longus tendon just passed the tip of the distal fibula. This area was wedge resected. The split longitudal tearing including this wedged area was then repaired with a running 4-0 Prolene suture to help tubularize the tendon and smooth its edges and surfaces. At this point, the stability of the tendons was assessed and it was not felt necessary to actually do any bone work to create a bigger grove, certainly the left 3 to 4 cm of the distal fibula groove was well sufficient given its fibrocartilaginous rim, which was not disrupted from the lateral surface of the fibula. The retinaculum was then repaired with a vest-over-pants method 2-0 Vicryl. This was supplemented with a piece of Biotape tagged in place with 3-0 Vicryl over the retinacular suture line. Finally, irrigations were done and closure was with interrupted 2-0 Vicryl and 4-0 nylon for the skin.
Operative Diagnosis:
1. Debridement of infamed tissue from within the peroneal tendon sheath, right ankle.
2. Repair of longitudal split tear of the peroneus longus tendon.
3. Debulking of the peroneus longus muscle distally in the groove.
4. Reefing and repair with augmentation of the peroneal retinaculum, right ankle.
A gently curved incision was made tracking the course of the distal peroneal tendond behind the fibula and then turning on to the foot. The peroneal retinaculum was uncovered and opened longitudinally leaving a flap attached to the distal fibula. The tendons were delivered and extensively debrided of tenosynovitic tissue. It was noted that the peroneus longus muscle extended much rather distally than its usual really passed the tip of the distal fibula. There was also an accessory tendon associated with that muscle tissue. This material was debrided away. There was a fusiform enlargement in the longus tendon just passed the tip of the distal fibula. This area was wedge resected. The split longitudal tearing including this wedged area was then repaired with a running 4-0 Prolene suture to help tubularize the tendon and smooth its edges and surfaces. At this point, the stability of the tendons was assessed and it was not felt necessary to actually do any bone work to create a bigger grove, certainly the left 3 to 4 cm of the distal fibula groove was well sufficient given its fibrocartilaginous rim, which was not disrupted from the lateral surface of the fibula. The retinaculum was then repaired with a vest-over-pants method 2-0 Vicryl. This was supplemented with a piece of Biotape tagged in place with 3-0 Vicryl over the retinacular suture line. Finally, irrigations were done and closure was with interrupted 2-0 Vicryl and 4-0 nylon for the skin.