scooter1
Expert
I am thinking 26356, but need opinions. I rarely do hands . . . please 
Doctor states he did Advancement of FDP into the head of the middle phalanx right middle finger.
That part of the report reads: I elected to see if the profundus would be possible to tenolyse. I went back to my palmar incision. Following the tendon distally, it became evident that it had in fact retracted to the level of the middle phalanx, it had been tethered there by the vincula & that it had not retracted into the palm. I made sure the flexor sheath was competent. I then made an incision overlying the middle phalanx of the rt middle finger. I dissected through subcutaneous tissues & identified the flexor sheath of the sublimis tendon which had left the two tails overlying the middle phalanx, but it had essentially left behind just the stumps of the tendons. I removed these. I then followed the flexor sheath distally. AT THIS POINT I anticipated that I would advance the flexor digitorum profundus to the level of the head of the middle phalanx which would be the best location mechanically for the PIP joint motion. I now used a G!! Quikanchor Plus. I cleaned the periosteum over the head to middle phalanx. I drilled for my fixation. I anchored the GII anchor in position & checked to ensure it locked in place. I then advanced the flexor digitorum profundus through the flexor sheath out to the head of the middle phalanx. I then used a modified Kessler stitch & tightly re-approximated the tendon to the fresh bone. I also took part of the flexor sheath & reinforced my attachment.
Doctor states he did Advancement of FDP into the head of the middle phalanx right middle finger.
That part of the report reads: I elected to see if the profundus would be possible to tenolyse. I went back to my palmar incision. Following the tendon distally, it became evident that it had in fact retracted to the level of the middle phalanx, it had been tethered there by the vincula & that it had not retracted into the palm. I made sure the flexor sheath was competent. I then made an incision overlying the middle phalanx of the rt middle finger. I dissected through subcutaneous tissues & identified the flexor sheath of the sublimis tendon which had left the two tails overlying the middle phalanx, but it had essentially left behind just the stumps of the tendons. I removed these. I then followed the flexor sheath distally. AT THIS POINT I anticipated that I would advance the flexor digitorum profundus to the level of the head of the middle phalanx which would be the best location mechanically for the PIP joint motion. I now used a G!! Quikanchor Plus. I cleaned the periosteum over the head to middle phalanx. I drilled for my fixation. I anchored the GII anchor in position & checked to ensure it locked in place. I then advanced the flexor digitorum profundus through the flexor sheath out to the head of the middle phalanx. I then used a modified Kessler stitch & tightly re-approximated the tendon to the fresh bone. I also took part of the flexor sheath & reinforced my attachment.