kellit21
Guru
Can anyone help me code this surgery???
Diagnosis: Chronic insertional Achilles tendinitis
Operation:
1. Takedown and debridement of terminal Achilles tendon
2. Posterior calcaneal exostectomy
3. Flexor halluces longus tendon transfer
4. Re-attachment of Achilles tendon to the calcaneus.
Description (in-part):
A posterior midline incision was made to the Achilles insertion. Dissection was carried within the tendon sheath until the was fully and able to be visualized. It was then sharply dissected off the bone, leaving as much length as possible. The terminal end of the tendon was debrided, including 1 fairly large area of calcification proximally of 4X8 mm.
Exostectomy was then performed, removing a portion of the posterior process and angle, as well as the heaped up bone in the former insertional site. This area was smoothed and roughened for acceptance of later tendon transfer and then re-attachment of the Achilles.
Dissection was carried along the medial site of the calcaneus until the flexor halluces longus was identified. It was then traced down to its tunnel and released at this point, leaving just about 2 cm as a tendon stump that could be buried within the calcaneal tunnel. The calcaneal tunnel was created over the guide pin. The tendon was whipstitched with a TigerLoop. The sutures were then passed through the beath pin through the plantar surface of the heel. Note that a 6 mm diameter tunnel was created. The tendon stump was then passed into the tunnel using the beath pin, and held in place with a 6.5 interference screw with excellent purchase.
The Achilles tendon was then reattached with 4 separate suture anchors at the corners of the insertional zone.
Diagnosis: Chronic insertional Achilles tendinitis
Operation:
1. Takedown and debridement of terminal Achilles tendon
2. Posterior calcaneal exostectomy
3. Flexor halluces longus tendon transfer
4. Re-attachment of Achilles tendon to the calcaneus.
Description (in-part):
A posterior midline incision was made to the Achilles insertion. Dissection was carried within the tendon sheath until the was fully and able to be visualized. It was then sharply dissected off the bone, leaving as much length as possible. The terminal end of the tendon was debrided, including 1 fairly large area of calcification proximally of 4X8 mm.
Exostectomy was then performed, removing a portion of the posterior process and angle, as well as the heaped up bone in the former insertional site. This area was smoothed and roughened for acceptance of later tendon transfer and then re-attachment of the Achilles.
Dissection was carried along the medial site of the calcaneus until the flexor halluces longus was identified. It was then traced down to its tunnel and released at this point, leaving just about 2 cm as a tendon stump that could be buried within the calcaneal tunnel. The calcaneal tunnel was created over the guide pin. The tendon was whipstitched with a TigerLoop. The sutures were then passed through the beath pin through the plantar surface of the heel. Note that a 6 mm diameter tunnel was created. The tendon stump was then passed into the tunnel using the beath pin, and held in place with a 6.5 interference screw with excellent purchase.
The Achilles tendon was then reattached with 4 separate suture anchors at the corners of the insertional zone.
