thumb collateral ligament

[Jamie Dezenzo]

PRE/POSTOPERATIVE DIAGNOSIS: Right thumb ulnar collateral ligament disruption.

PROCEDURE PERFORMED: Right thumb ulnar collateral ligament reconstruction with tendon transfer and tendon graft reconstruction.

INDICATIONS: This man has a disruption of his ulnar collateral ligament of the thumb and is admitted for secondary reconstruction.

PROCEDURE: The patient was brought to the operating room; the right arm was prepped, draped and exsanguinated.

A longitudinal incision was made over the thumb over the metacarpophalangeal (MP) joint, the skin flaps elevated, the extensor shroud released, tendon pulled back, the adductor attachment released and the ulnar collateral ligament identified. It was grossly incompetent and irreparable. There was gross instability of the ulnar collateral ligament and inadequate soft tissue for augmentation.

Two separate incisions were made on the volar side over the forearm and the palmaris longus tendon harvested. This was then denuded of muscle and 2 bony passageways were created in the thumb metacarpal and the proximal phalanx and then a figure-of-eight tendon graft carried out, using the palmaris longus tendon, secured with multiple 3-0 Ticron sutures (26489). The adductor pollicis tendon was used to augment the repair with a Statak screw disc plate (26542). The repair was taut and motion was allowed. The wound was then irrigated. Hemostasis secured. Skin closed with 4-0 nylon. Dry dressing applied to the wound. The patient was transferred to the recovery room in satisfactory condition.

I'm looking at 26542 for the adductor pollicis tendon and 26489 for the palmaris longus tendon transfer?

Any thoughts!!

THANKS
Jamie

[Jamie Dezenzo]

Thanks for any help!