Ccgerson
Guest
20103 is a "separate procedure". But I'm not sure if that applies more to debridement and closure of the wound, and if it can be used in addition to tendon and/or nerve repairs in the same location.
This is a portion of the OP note:
The distal forearm laceration was extended distally in a zigzag fashion. The subcutaneous tissues dissected using spreading motions with Littler scissors. Hemostasis was maintained with bipolar electrocautery. The wound was explored. Hematoma was removed. The wound was irrigated copiously with sterile saline by bulb syringe. The FCU tendon was identified and was found to be lacerated approximate 70% on the ulnar side. The underlying ulnar nerve was completely transected. Artery was intact. The FDS and FDP tendons were individually identified and inspected. Each the tendons was intact, including FDP to the small finger, however there was laceration into the muscle bellies of the FDP tendon on the ulnar aspect.
*
Attention was turned to the ulnar nerve repair. The operating microscope was brought to the field. The nerve was further isolated and freed using microsurgical HM is a microsurgical techniques. Both ends of the nerve were trimmed back to healthy-appearing fascicles using microsurgical scissors. The nerve was repaired using 8-0 nylon sutures placed circumferentially in the epineurium.
*
Attention was then turned to the flexor carpi ulnaris tendon repair in zone 5. The 70% laceration was repaired using 4-0 FiberWire sutures in a modified Kessler pattern, then oversewn with an additional figure-of-eight.
Thank you,
Cindy
This is a portion of the OP note:
The distal forearm laceration was extended distally in a zigzag fashion. The subcutaneous tissues dissected using spreading motions with Littler scissors. Hemostasis was maintained with bipolar electrocautery. The wound was explored. Hematoma was removed. The wound was irrigated copiously with sterile saline by bulb syringe. The FCU tendon was identified and was found to be lacerated approximate 70% on the ulnar side. The underlying ulnar nerve was completely transected. Artery was intact. The FDS and FDP tendons were individually identified and inspected. Each the tendons was intact, including FDP to the small finger, however there was laceration into the muscle bellies of the FDP tendon on the ulnar aspect.
*
Attention was turned to the ulnar nerve repair. The operating microscope was brought to the field. The nerve was further isolated and freed using microsurgical HM is a microsurgical techniques. Both ends of the nerve were trimmed back to healthy-appearing fascicles using microsurgical scissors. The nerve was repaired using 8-0 nylon sutures placed circumferentially in the epineurium.
*
Attention was then turned to the flexor carpi ulnaris tendon repair in zone 5. The 70% laceration was repaired using 4-0 FiberWire sutures in a modified Kessler pattern, then oversewn with an additional figure-of-eight.
Thank you,
Cindy