KatieGal
Guest
Is a talonavicular arthrodesis part of a triple arthrodesis? I have read that it is, but would like some opinions as to the correct procedure code to use.
"An incision was made over the talonavicular joint. Dissection continued down through subcutaneous tissue to the joint where a superior medial arthrotomy was made. The dorsal osteophyte over the talar neck was then removed. The joint was then curetted, curetting both sides of the joint, removing any remaining joint surface which was primarily sclerotic. The surfaces were both fish-scaled. Bone grafts and platelet gel were then placed into the fusion site. Attempt was made at placing 2 Arthrex staples. There was concern in initial placement that the talar neck was somewhat more lateral than it should have been and the navicular tuberosity was more medial than it should have been. Therefore, the 1st staple was removed. Attention was then made at trying to place a 2nd staple lateralizing the navicular tuberosity. This resulted in widening of the gap and an incongruent fusion site. This staple was then removed.
It was felt that even though the navicular tuberosity was more medial than normal, that on feeling his other under the drapes it was felt that this was his normal anatomy and it was felt that if we tried to lateralize the navicular tuberosity that the talonavicular joint would be incongruent and the fusion would be gapped and therefore it was placed in what was thought to be its normal anatomic position which meant that the navicular tuberosity was slightly more medial. Two staples were then placed with good compression obtained."
Thank you for helping me
"An incision was made over the talonavicular joint. Dissection continued down through subcutaneous tissue to the joint where a superior medial arthrotomy was made. The dorsal osteophyte over the talar neck was then removed. The joint was then curetted, curetting both sides of the joint, removing any remaining joint surface which was primarily sclerotic. The surfaces were both fish-scaled. Bone grafts and platelet gel were then placed into the fusion site. Attempt was made at placing 2 Arthrex staples. There was concern in initial placement that the talar neck was somewhat more lateral than it should have been and the navicular tuberosity was more medial than it should have been. Therefore, the 1st staple was removed. Attention was then made at trying to place a 2nd staple lateralizing the navicular tuberosity. This resulted in widening of the gap and an incongruent fusion site. This staple was then removed.
It was felt that even though the navicular tuberosity was more medial than normal, that on feeling his other under the drapes it was felt that this was his normal anatomy and it was felt that if we tried to lateralize the navicular tuberosity that the talonavicular joint would be incongruent and the fusion would be gapped and therefore it was placed in what was thought to be its normal anatomic position which meant that the navicular tuberosity was slightly more medial. Two staples were then placed with good compression obtained."
Thank you for helping me