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Can anyone tell me what they use for a helical blade exchange? I was thinking 27245-52 but would like another opinion if possible. Thanks.
PROCEDURE AND FINDINGS: General anesthesia was induced. Prophylactic
antibiotics were given. Timeout was called. The patient, surgical
site, and procedure were verified. Ross Olson, CNP, performed patient
positioning, assistance with preparation and draping, assistance with
efficient and accurate completion of procedure, hemostasis by precise
cautery, meticulous closure of subcutaneous tissue and skin, and
dressing application.
The patient was carefully turned to the left-side-down lateral
decubitus position on the Capello pegboard. Axillary roll was placed.
All nerves and bony prominences were carefully padded. Pegs were
placed in appropriate positions to stabilize the pelvis. Right thigh
and hip were then prepped and draped in the standard sterile surgical
fashion.
A preexisting proximal lateral thigh incision was utilized. This was
carried sharply through skin and subcutaneous tissue. Incision was
extended distally an additional 5 cm. Incision was then carried all
the way down to fascia. The fascia was opened longitudinally, and the
tip of the trochanter was identified. A curette was used to expose the
proximal end of the rod, removing some bone formation from within the
top of the rod. Appropriate-sized screwdriver was then placed in the
top of the rod to loosen the locking mechanism.
Attention was then turned to the more distal thigh wound. A 5-cm long
longitudinal incision was made sharply through skin and subcutaneous
tissue, utilizing preexisting scar. IT band was opened longitudinally.
The existing base of the helical blade was exposed. Extraction device
was placed on the helical blade, and it was easily pulled from the
femur. A guidewire was then placed back into the femoral neck and head
through the same hole. The existing helical blade was 105 mm in
length. A new lag screw, 90 mm in length, was placed. Intraoperative
imaging confirmed the tip of the screw at a safe distance of 1 to 1.5
cm from the articular surface of the femoral head. The locking
mechanism was again tightened through the top of the nail. The wound
was thoroughly irrigated with normal saline. Final fluoroscopic images
were saved.
Deep fascia of both wounds was repaired with interrupted #1 Polysorb
suture. Deep subcutaneous layers were closed with interrupted 0
Polysorb suture, superficial subcutaneous layer with interrupted 2-0
Polysorb suture, and skin was closed with staples. Sterile dressings
were applied. The patient was awoken and sent to recovery in stable
condition. There were no complications. Blood loss was less than 30
mL.
PROCEDURE AND FINDINGS: General anesthesia was induced. Prophylactic
antibiotics were given. Timeout was called. The patient, surgical
site, and procedure were verified. Ross Olson, CNP, performed patient
positioning, assistance with preparation and draping, assistance with
efficient and accurate completion of procedure, hemostasis by precise
cautery, meticulous closure of subcutaneous tissue and skin, and
dressing application.
The patient was carefully turned to the left-side-down lateral
decubitus position on the Capello pegboard. Axillary roll was placed.
All nerves and bony prominences were carefully padded. Pegs were
placed in appropriate positions to stabilize the pelvis. Right thigh
and hip were then prepped and draped in the standard sterile surgical
fashion.
A preexisting proximal lateral thigh incision was utilized. This was
carried sharply through skin and subcutaneous tissue. Incision was
extended distally an additional 5 cm. Incision was then carried all
the way down to fascia. The fascia was opened longitudinally, and the
tip of the trochanter was identified. A curette was used to expose the
proximal end of the rod, removing some bone formation from within the
top of the rod. Appropriate-sized screwdriver was then placed in the
top of the rod to loosen the locking mechanism.
Attention was then turned to the more distal thigh wound. A 5-cm long
longitudinal incision was made sharply through skin and subcutaneous
tissue, utilizing preexisting scar. IT band was opened longitudinally.
The existing base of the helical blade was exposed. Extraction device
was placed on the helical blade, and it was easily pulled from the
femur. A guidewire was then placed back into the femoral neck and head
through the same hole. The existing helical blade was 105 mm in
length. A new lag screw, 90 mm in length, was placed. Intraoperative
imaging confirmed the tip of the screw at a safe distance of 1 to 1.5
cm from the articular surface of the femoral head. The locking
mechanism was again tightened through the top of the nail. The wound
was thoroughly irrigated with normal saline. Final fluoroscopic images
were saved.
Deep fascia of both wounds was repaired with interrupted #1 Polysorb
suture. Deep subcutaneous layers were closed with interrupted 0
Polysorb suture, superficial subcutaneous layer with interrupted 2-0
Polysorb suture, and skin was closed with staples. Sterile dressings
were applied. The patient was awoken and sent to recovery in stable
condition. There were no complications. Blood loss was less than 30
mL.