Desperate Denise
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I would really appreciate it if someone could help me code this one.
Your assistance will be so greatly appreciated.
Thank you - Denise
PROCEDURES: Right shoulder arthroscopy, coracoclavicular ligament
reconstruction, partial rotator cuff debridement, type 1 partial
labral debridement, bursectomy.
INDICATIONS: The patient is a 47-year-old who has complaints of pain
in his right arm after an AC separation with elevation of the clavicle
and depression of his scapula. Risks and benefits of surgery were
discussed with the patient including bleeding, infection, nerve artery
damage, failure to improve his pain, persistent pain, need for further
surgery, and he wished to proceed.
DESCRIPTION OF PROCEDURE: The patient was brought to the operating
room, placed supine on the operating room table. After induction of
general anesthetic and an interscalene block, he was placed in the
beach chair position, all bony prominences were padded. His right
shoulder was prepped and draped in the standard surgical fashion.
Posterior portal was created. Examination of joint showed normal
glenohumeral articular surfaces. The subscapularis was intact. The
biceps tendon and anchor were intact. There was a type 1 labral tear
anteriorly which was debrided with a 3.5 mm full-radius shaver.
Supraspinatus had a small fraying of the rotator cuff and a 3.5 shaver
was used to perform a partial rotator cuff debridement. The inferior
glenohumeral ligament was intact. The posterior labrum was intact.
Attention was directed to the subacromial space where bursitis was
seen and debrided with a 3.5 mm, full-radius shaver and a TurboVac
wand. Rotator cuff was intact from above. Attention was then
directed towards the anterior shoulder where a dissection was carried
down through skin and subcutaneous tissue. The superior aspect of the
clavicle was incised. The periosteum was elevated along the clavicle
edges. Then 10 mm of the distal clavicle were excised. Attention was
directed distally where the coracoid process was identified and the
periosteum was elevated again. The 4 drill holes were then placed
into the clavicle. Two 5.5 Arthrex PEEK anchors were placed into the
coracoid and sutures were passed through the drill holes. With the
arm supported and the clavicle reduced the acromion, the sutures were
tied down superiorly. The arm could be brought into full range of
motion afterwards. The arm was unsupported. The AC joint was well
reduced. The incision was irrigated. The deltoid fascia was closed
with 0 Vicryl suture. The 2-0 Vicryl in subcutaneous tissue, 4-0
Monocryl on the skin. Steri-Strips and dry sterile dressing were
applied. The patient tolerated the procedure well and returned to
recovery in stable condition.
Your assistance will be so greatly appreciated.
Thank you - Denise
PROCEDURES: Right shoulder arthroscopy, coracoclavicular ligament
reconstruction, partial rotator cuff debridement, type 1 partial
labral debridement, bursectomy.
INDICATIONS: The patient is a 47-year-old who has complaints of pain
in his right arm after an AC separation with elevation of the clavicle
and depression of his scapula. Risks and benefits of surgery were
discussed with the patient including bleeding, infection, nerve artery
damage, failure to improve his pain, persistent pain, need for further
surgery, and he wished to proceed.
DESCRIPTION OF PROCEDURE: The patient was brought to the operating
room, placed supine on the operating room table. After induction of
general anesthetic and an interscalene block, he was placed in the
beach chair position, all bony prominences were padded. His right
shoulder was prepped and draped in the standard surgical fashion.
Posterior portal was created. Examination of joint showed normal
glenohumeral articular surfaces. The subscapularis was intact. The
biceps tendon and anchor were intact. There was a type 1 labral tear
anteriorly which was debrided with a 3.5 mm full-radius shaver.
Supraspinatus had a small fraying of the rotator cuff and a 3.5 shaver
was used to perform a partial rotator cuff debridement. The inferior
glenohumeral ligament was intact. The posterior labrum was intact.
Attention was directed to the subacromial space where bursitis was
seen and debrided with a 3.5 mm, full-radius shaver and a TurboVac
wand. Rotator cuff was intact from above. Attention was then
directed towards the anterior shoulder where a dissection was carried
down through skin and subcutaneous tissue. The superior aspect of the
clavicle was incised. The periosteum was elevated along the clavicle
edges. Then 10 mm of the distal clavicle were excised. Attention was
directed distally where the coracoid process was identified and the
periosteum was elevated again. The 4 drill holes were then placed
into the clavicle. Two 5.5 Arthrex PEEK anchors were placed into the
coracoid and sutures were passed through the drill holes. With the
arm supported and the clavicle reduced the acromion, the sutures were
tied down superiorly. The arm could be brought into full range of
motion afterwards. The arm was unsupported. The AC joint was well
reduced. The incision was irrigated. The deltoid fascia was closed
with 0 Vicryl suture. The 2-0 Vicryl in subcutaneous tissue, 4-0
Monocryl on the skin. Steri-Strips and dry sterile dressing were
applied. The patient tolerated the procedure well and returned to
recovery in stable condition.