Excision distal tip of femoral strut graft


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Good morning! Can anyone help me with this??

Pre & post op dx: Status post femoral strut corical grafting for stress fx of rt femur.

Surgical procedure: Excision of distal tip of femoral strut graft.

Indications: 67 yr old female w/history of stress fracture which was non healing for 6-9 months. She presented to sx for femoral strut grafting. The distal portion of the anterior strut graft was somewhat prominent and is bothersome and she has decided to proceed w/excision of just this distal tip. we plan to allow the remaining portion of the strut in place w/wires throught for continued healing of this area.

Procedure:...AP and lateral Fluoroscan had been used to localize this incision and now was used to localize the blunt dissection. Dissection was made distally between the intermedius and the lateralis of the quads approx 1.5 cm. Identification was then performed, blunt Homan retractor was placed. A curved osteotome was placed around the anterior strut to protect the distal femur. Using a small hand micro saw, this was then cut at an angle to allow appropriate contouring of the femoral strut. Palpation of the femur showed good intact, no evidence of nicking of the area and the rest of the strut was excised with the Bovie cautery. Hemostasis was obtained with Aquamanits, area copiously irrigated out, remaining hemostasis obtained. The quadriceps muscle was then closed w/2-0 interlockin Vicryl. TFL closed with 0 interlocking Vicryl, subcutaneous was closed in layers w 2-0 vicryl. Skin closed with running subcuticular stitch....

Any help with this would be greatly appreciated!

Cathy Heusman, CPC