coders_rock!
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Can someome please help me code this?
Pre/Post-Op Dx: LT distal radius malunion w/symptomatic hardware.
Procedure:
The patient's volar plate was removed. I made an osteotomy to the articular surface. I osteotomized the ulnar cortex and the volar cortex. A cut was made in the volar cortex of the bone that went up to the joint surface. This freed up the depressed piece of bone. I levered out the joint surface. K-wire was placed from radial to medial to catch the fragment and keep it elevated. The volar plate was replaced. I repositioned the plate so that the ulnar aspect of the plate would attach the ulnar fragment.
I fixed the plate to the bone with screw holes. Then, I placed K-wires in the 2 holes in the transverse limb of the plate. I drilled the proximal row of the PEG holes. I placed pegs in all these holes. I also drilled in the most ulnar hole in the distal row of the plate. I placed a PEG in this hole as well to capture the free fragment. I took radiographs. I removed the most ulnar plate and replaced it with a new one. I then placed screws in the radial shaft.
I opted to leave the K-wire in place to keep that fragment supported while waiting bone healing. Final radiographs were taken.
Pre/Post-Op Dx: LT distal radius malunion w/symptomatic hardware.
Procedure:
The patient's volar plate was removed. I made an osteotomy to the articular surface. I osteotomized the ulnar cortex and the volar cortex. A cut was made in the volar cortex of the bone that went up to the joint surface. This freed up the depressed piece of bone. I levered out the joint surface. K-wire was placed from radial to medial to catch the fragment and keep it elevated. The volar plate was replaced. I repositioned the plate so that the ulnar aspect of the plate would attach the ulnar fragment.
I fixed the plate to the bone with screw holes. Then, I placed K-wires in the 2 holes in the transverse limb of the plate. I drilled the proximal row of the PEG holes. I placed pegs in all these holes. I also drilled in the most ulnar hole in the distal row of the plate. I placed a PEG in this hole as well to capture the free fragment. I took radiographs. I removed the most ulnar plate and replaced it with a new one. I then placed screws in the radial shaft.
I opted to leave the K-wire in place to keep that fragment supported while waiting bone healing. Final radiographs were taken.