slscott
New
Procedures Performed:
Left wrist dorsal mass excision
Left arthroplasty of the radiocarpal joint and removal of the stalk.
Tenolysis of the extensor tendons of the EDC and ECRL
Procedures :
The left arm was then the sterilely prepped and draped and a tourniquet was placed. The arm was then elevated to gravity only and the tourniquet was inflated to 250mm hg.
Attention was now paid to the left dorsal wrist mass. A transverse incision was made over the dorsal mass and care was taken not to violate the mass. The mass appeared to be multiloculated and the fluid was aspirated there was a combination of bursitis with chronic changes and significant scarring of the extensor tendons that precluded gliding. One of the masses appeared to be a ganglion and this was followed to the radiocarpal joint and there was a lot of scar tissue and septations within it. It was removed and sent to the pathologist as was the fluid.
Next attention was then taken to the left radiocarpal joint where an arthroplasty was performed with a single action ronguer and a dorsal rim of the capsule was removed. The extensor tendons appeared to be frayed and would not glide well so tenolysis knives and dilators were used to promote excursion with marked improvement of the EDC and the ECRL. At this time a copious amount of irrigation was used followed by local field blocks were then placed and a layered closure was then performed.
The patient tolerated all procedures well and sterile dressings were applied. The Tourniquet was deflated and patient was transferred to the recovery room under stable condition. Patient will be discharged home when stable. Patient will be discharged home on pain medications. Patient was instructed to go to the emergency room if having any medical problems between now and the follow-up. Patient was given follow-up instructions.
pathology for excision is ganglion 25111
arthroplasty 25332
but, would the tenolysis be included with the arthroplasty?
Left wrist dorsal mass excision
Left arthroplasty of the radiocarpal joint and removal of the stalk.
Tenolysis of the extensor tendons of the EDC and ECRL
Procedures :
The left arm was then the sterilely prepped and draped and a tourniquet was placed. The arm was then elevated to gravity only and the tourniquet was inflated to 250mm hg.
Attention was now paid to the left dorsal wrist mass. A transverse incision was made over the dorsal mass and care was taken not to violate the mass. The mass appeared to be multiloculated and the fluid was aspirated there was a combination of bursitis with chronic changes and significant scarring of the extensor tendons that precluded gliding. One of the masses appeared to be a ganglion and this was followed to the radiocarpal joint and there was a lot of scar tissue and septations within it. It was removed and sent to the pathologist as was the fluid.
Next attention was then taken to the left radiocarpal joint where an arthroplasty was performed with a single action ronguer and a dorsal rim of the capsule was removed. The extensor tendons appeared to be frayed and would not glide well so tenolysis knives and dilators were used to promote excursion with marked improvement of the EDC and the ECRL. At this time a copious amount of irrigation was used followed by local field blocks were then placed and a layered closure was then performed.
The patient tolerated all procedures well and sterile dressings were applied. The Tourniquet was deflated and patient was transferred to the recovery room under stable condition. Patient will be discharged home when stable. Patient will be discharged home on pain medications. Patient was instructed to go to the emergency room if having any medical problems between now and the follow-up. Patient was given follow-up instructions.
pathology for excision is ganglion 25111
arthroplasty 25332
but, would the tenolysis be included with the arthroplasty?