Hello,
I am needing some assistance with this op report if anyone can help that would be great:
Lt hand palmaris longus tendon transfer to Lt thumb extensor pollicis brevis(opponensplasty)
Lt carpal tunnel release
I made an incision over the carpal tunnel and I extended this in an ulnar oblique incision across the wrist crease. A sharp dissection was carried through the skin and subcutaneous tissue. I was able to identify the palmaris longus tendon and this was isolated. I then elevated up the soft tisse ove the top of the palmar aponeurosis. I extended the palmaris longus with a strip of this aponeurosis approx 2 cm in length. I was able to elevate this up completley and isolate the palmaris longus tendon. This was then moved to the side. Deep to this, I could see the transverse carpal ligament. This was divided longitudinally. Deep to this I could seee the median nerve which was compressed and decreased vascular markings and was flattened. I was able to take the pressure off completley distally to the level of the perivascular fat. I could see the superficial palmar branch taht was still intact. I copiously irrigated this wound. I was able to tunnel subcutaneously from this wound to the dorsal thumb metacarpal. I made a longitudinal incision over the distal thumb metacarpal. Deep to this, I was able to see come cutaneous nerves which were dissected down and protected, I was able to find the extensor pollicis brevis tendon and this was also isolated. I then used a tendon passer to pass the palmaris longus tendon through this tunnel up and over to the pollicis brevis tendon and grasped the palmaris longus. I then tensioned it with the wrist straight and with the thumb in maximal opposition. Pulling this in place, I was able to then tie it down and I could see there was excellent opposition of the thumb. I then passed this one additional time to the extensor pollicis brevis with the weaver and sew this in place.
Any takers?
I was thinking either 25310 or 26496 along with the 64721
any help would be appreciated!
I am needing some assistance with this op report if anyone can help that would be great:
Lt hand palmaris longus tendon transfer to Lt thumb extensor pollicis brevis(opponensplasty)
Lt carpal tunnel release
I made an incision over the carpal tunnel and I extended this in an ulnar oblique incision across the wrist crease. A sharp dissection was carried through the skin and subcutaneous tissue. I was able to identify the palmaris longus tendon and this was isolated. I then elevated up the soft tisse ove the top of the palmar aponeurosis. I extended the palmaris longus with a strip of this aponeurosis approx 2 cm in length. I was able to elevate this up completley and isolate the palmaris longus tendon. This was then moved to the side. Deep to this, I could see the transverse carpal ligament. This was divided longitudinally. Deep to this I could seee the median nerve which was compressed and decreased vascular markings and was flattened. I was able to take the pressure off completley distally to the level of the perivascular fat. I could see the superficial palmar branch taht was still intact. I copiously irrigated this wound. I was able to tunnel subcutaneously from this wound to the dorsal thumb metacarpal. I made a longitudinal incision over the distal thumb metacarpal. Deep to this, I was able to see come cutaneous nerves which were dissected down and protected, I was able to find the extensor pollicis brevis tendon and this was also isolated. I then used a tendon passer to pass the palmaris longus tendon through this tunnel up and over to the pollicis brevis tendon and grasped the palmaris longus. I then tensioned it with the wrist straight and with the thumb in maximal opposition. Pulling this in place, I was able to then tie it down and I could see there was excellent opposition of the thumb. I then passed this one additional time to the extensor pollicis brevis with the weaver and sew this in place.
Any takers?
I was thinking either 25310 or 26496 along with the 64721
any help would be appreciated!