LindsayAllen
New
Would this still be 20680???
Patient was brought to operating room general anesthetic administered. The leg was prepped and draped in standard fashion. An approximately 3 cm incision overlying the nail longitudinally was made. Incision was readily carried down to the top of the nail which was identified and cleared of fibrous tissue. The extracting device was placed within the nail and threaded as far and as much as possible. multiple attempts at extraction of the nail by multiple different people resulted in absolutely no movement of the nail. It was my concern that any further attempts might actually split the tibia and even doing so would be extremely problematic getting the nail out at all. Therefore, given the prominence of the most proximal aspect of the nail, which had been the cause of the patient's symptoms, I elected to simply remove the part of the nail with a diamond cutting bur. This was done carefully and all remnants of stainless steel were removed from the wound with multiple irrigation. The wound was then closed using 0 Vicryl for deep tissue, 2-0 Monocryl for subcutaneous tissue and 3-0 monocryl vertical mattress sutures for skin. The patient tolerated the procedure well and was taken to recovery room in satisfactory condition.
Patient was brought to operating room general anesthetic administered. The leg was prepped and draped in standard fashion. An approximately 3 cm incision overlying the nail longitudinally was made. Incision was readily carried down to the top of the nail which was identified and cleared of fibrous tissue. The extracting device was placed within the nail and threaded as far and as much as possible. multiple attempts at extraction of the nail by multiple different people resulted in absolutely no movement of the nail. It was my concern that any further attempts might actually split the tibia and even doing so would be extremely problematic getting the nail out at all. Therefore, given the prominence of the most proximal aspect of the nail, which had been the cause of the patient's symptoms, I elected to simply remove the part of the nail with a diamond cutting bur. This was done carefully and all remnants of stainless steel were removed from the wound with multiple irrigation. The wound was then closed using 0 Vicryl for deep tissue, 2-0 Monocryl for subcutaneous tissue and 3-0 monocryl vertical mattress sutures for skin. The patient tolerated the procedure well and was taken to recovery room in satisfactory condition.