ggparker14
True Blue
- Messages
- 634
- Best answers
- 0
What CPT to use on the following procedures:
Exploration of right leg, removal of two foreign bodies from the right ankle area of the right leg, debridement of fracture of the medial tibial metaphysis right ankle, debridement of soft tissues.
The metal was projecting from the anterior medial aspect of the supramalleolar area of the ankle was examined under fluoroscopy. The wire was seen to penetrate posterior medially. With fluroscopic control the bent end of the wire and the soft tissues was identified, landmark was placed. An incision was then made over the deep portion of the foreign body taking care to avoid injury to the neurovascular bundle and tendons. Dissection was carried down. The wire was identified. The bent tip was cut with wire cutters and removed from the field. The remainder of the wire was then passed through the new incision and exited. Fluoroscopy was then placed on the leg and examined. There was again noted a foreign body about one inch long of wire. Through the original wound the second foreign body was removed. The fluroscopy revealed an irregularity in the medial cortex metaphysis of the distal tibia. The original wound was then incised posteriorly opening the original wound. The tibia was explored in this area and there was seen a partial thickness fracture with some loss of cortex and a metaphyseal bone expose. There was no displaceable fracture of the distal tibia medially. The wound under direct vision was curetted to remove any foreign material that was not grossly contaminated. It was then copiously irrigated with normal salin containing antibiotic. Then working through the original track a flexible catheter was placed and further irrigation was carried out to flush out any further foreign material. Soft tissue staining was removed, particulary around original puncture wound sharply incising the skin. Further irrigation was carried out. A small Penrose drain was placed in the posterior incision. The incision was closed loosely with 40-0 Monofilament steel wire. The extended incision on the original wound was also closed with 4-0 wire leaving the original wound open to drain. A Robert Jones short-leg slipper cast was applied.
Thanks for any help.
Exploration of right leg, removal of two foreign bodies from the right ankle area of the right leg, debridement of fracture of the medial tibial metaphysis right ankle, debridement of soft tissues.
The metal was projecting from the anterior medial aspect of the supramalleolar area of the ankle was examined under fluoroscopy. The wire was seen to penetrate posterior medially. With fluroscopic control the bent end of the wire and the soft tissues was identified, landmark was placed. An incision was then made over the deep portion of the foreign body taking care to avoid injury to the neurovascular bundle and tendons. Dissection was carried down. The wire was identified. The bent tip was cut with wire cutters and removed from the field. The remainder of the wire was then passed through the new incision and exited. Fluoroscopy was then placed on the leg and examined. There was again noted a foreign body about one inch long of wire. Through the original wound the second foreign body was removed. The fluroscopy revealed an irregularity in the medial cortex metaphysis of the distal tibia. The original wound was then incised posteriorly opening the original wound. The tibia was explored in this area and there was seen a partial thickness fracture with some loss of cortex and a metaphyseal bone expose. There was no displaceable fracture of the distal tibia medially. The wound under direct vision was curetted to remove any foreign material that was not grossly contaminated. It was then copiously irrigated with normal salin containing antibiotic. Then working through the original track a flexible catheter was placed and further irrigation was carried out to flush out any further foreign material. Soft tissue staining was removed, particulary around original puncture wound sharply incising the skin. Further irrigation was carried out. A small Penrose drain was placed in the posterior incision. The incision was closed loosely with 40-0 Monofilament steel wire. The extended incision on the original wound was also closed with 4-0 wire leaving the original wound open to drain. A Robert Jones short-leg slipper cast was applied.
Thanks for any help.
