Wiki New to ortho could someone please help?

MELJNBBRB

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PREOPERATIVE DIAGNOSES:
1. right distal radius fracture


POSTOPERATIVE DIAGNOSES:
Same


OPERATIONS PERFORMED:
Open reduction and internal fixation, right distal radius fracture


TOURNIQUET TIME:
0 mins.


ESTIMATED BLOOD LOSS:
minimal.


FLUIDS:
Per anesthesia record.


OPERATIVE FINDINGS:
One part DR fracture with moderate metaphyseal comminution, 10 degree dorsal tilt


OPERATIVE SUMMARY IN DETAIL:
Following appropriate informed consent, patient identification, and operative limb, the patient was brought to the operating suite where smooth induction of LMA anesthesia was accomplished by the anesthesiology service. Broad spectrum IV antibiotic prophylaxis was given. The right upper extremity was prepped and draped in the usually fashion and a time out was performed identifying patient, limb and procedure(s). The fracture was then expose using a longitudinal incision incision over the fourth extensor compartment. Provisional fixation with an intra-focal K-wire dorsally was performed and confirmed under fluoroscopy restoring anatomic volar tilt and radial inclination. A second K wire was then placed through the radial styloid to lock -in the reduction. The wires were then bent back onto themselves , rotated and advanced into low-profile position below the skin. Reduction and hardware placement was thus optimized. Wrist and DRUJ motion was unimpeded. Closure was performed with non absorbable sutures. Marcaine was used to infiltrate about the wound margins, periosteum and local peripheral nerves for perioperative pain relief. A sterile non-adherent dressing and short arm splint were applied and the patient was extubated and transferred to the recovery area with a warm, viable hand and digits times five. There were no intraoperative complications and the patient tolerated the procedure well

Thanks Melissa Bedford,CCS,CPC
 
I was looking at 25607 or 25608 but what is confusing me is how do I know if it is intra-articular or extra-articular? Thank you for your reply.
 
If the racture does not extend into the wrist joint it's extra-articular, if it does go into the wrist joint it's intra-articular. Your provider state that this was a metaphyseal fracture. The metaphysis (also known as the growth plate) is the portion between the ephysis (end of bone) and the diaphysis (shaft), From the documentation in this note, this seems to be an extra-articular fracture. If you're not sure, you should query the provider.
 
25607-RT for this. My docs are pretty good about telling me how many fragments. This one he states only 1 fragment. 25608 if its 2 fragments 25609 if its 3 or more.
 
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