jerseygirl20
Networker
postoperative dx codes-
bunion
degenerative joint disease
fracture fragment, right metatarsophalangeal joint-bilateral
procedures
modified mcbride bunionectomy
excision fragment, first metatarsophalangeal joint bilateral
debridement of joint bilateral with subchondral drilling
description of procedure:
Attention was then directed to the dorsal aspect of the first metatarsophalangeal joint where a 6 cm linear incision was made just medial to the extensor hallucis longus tendon. The incision was deepened via sharp and blunt dissection with care being taken to identify, retract and preserve all neeurovascular and tendon structures. All bleeders were clamped and ligated as necessary.
The capsule of the first metatarsalphalangeal joint was reached and a linear capsulotomy was perfomed. All capsular and perosteal tissues were reflected from the head and neck of the first metatarsal fand from the base of the proximal phalanx. A fracture fragment, the width of the first metatarsal head , was then identified. This was approx- 1 x1.5 cm in size. The fracture fragment was freed, excised and placed on the back table. The hypertrophic medial exostosis on the first metarsal head was excised. The hypertrophic lateral exotosis was then excised using bone rongeur. All spurs from the proximal phalanx was then removed utilizing bone rongeur. The rought edges were then all rasped smooth with a power rasp. The area of the cartilage on the dorsal aspect of the distal first metatarsal head was then drilled with 1.5 mm K wire withmultiple holes to encourage bone bleeding. The surgical site ws then flushed with copious amounts of sterile saline solution.
Then it was closed.
I am just not seeing both procedures here. So I am looking for some clarification on this case.
Thank you
bunion
degenerative joint disease
fracture fragment, right metatarsophalangeal joint-bilateral
procedures
modified mcbride bunionectomy
excision fragment, first metatarsophalangeal joint bilateral
debridement of joint bilateral with subchondral drilling
description of procedure:
Attention was then directed to the dorsal aspect of the first metatarsophalangeal joint where a 6 cm linear incision was made just medial to the extensor hallucis longus tendon. The incision was deepened via sharp and blunt dissection with care being taken to identify, retract and preserve all neeurovascular and tendon structures. All bleeders were clamped and ligated as necessary.
The capsule of the first metatarsalphalangeal joint was reached and a linear capsulotomy was perfomed. All capsular and perosteal tissues were reflected from the head and neck of the first metatarsal fand from the base of the proximal phalanx. A fracture fragment, the width of the first metatarsal head , was then identified. This was approx- 1 x1.5 cm in size. The fracture fragment was freed, excised and placed on the back table. The hypertrophic medial exostosis on the first metarsal head was excised. The hypertrophic lateral exotosis was then excised using bone rongeur. All spurs from the proximal phalanx was then removed utilizing bone rongeur. The rought edges were then all rasped smooth with a power rasp. The area of the cartilage on the dorsal aspect of the distal first metatarsal head was then drilled with 1.5 mm K wire withmultiple holes to encourage bone bleeding. The surgical site ws then flushed with copious amounts of sterile saline solution.
Then it was closed.
I am just not seeing both procedures here. So I am looking for some clarification on this case.
Thank you