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Debridement pip joint & bone

nabernhardt

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needing some help please with the procedure. Possibly 26235 or 11044? thanks
PREOPERATIVE DIAGNOSIS: Tophaceous gout left PIP joint.
POSTOPERATIVE DIAGNOSIS: Advanced destruction of the PIP joint and accompanying
bone from gouty changes.
OPERATION: Debridement of left PIP joint and bone.

HISTORY: The patient has had a progressive large gouty tophus, painful, restrictive and he
wants surgical intervention. Nonoperative management was maximized. He requested to proceed.
The risks, benefits, and alternatives were reviewed.
PROCEDURE: I made a small incision in the medial aspect of the finger after it was prepared and draped and he was locally anesthetized. I used a local tourniquet. The gouty debris was removed. Tendon destruction was encountered. The radial condyle of the PIP fell out of the wound. I débrided all the devitalized bone. No signs of infection. Thorough irrigation was performed. The patient tolerated the procedure well. Wound was closed. Hemostasis was noted.
 
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