Wiki Trimalleolar Fracture left ankle nd Proximal fibular fracture Coding

cwilson3333

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Location
Hamilton, VA
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Procedure Title
Open reduction with internal fixation left ankle
Looking at code 27822 for the ORIF of Trimalleolar Fracture
Also looking a 27823 and 27829


Brief summary of op note
Incision made of distal fibula; incision taken down through subcutaneous tissue. Fracture exposed and was curetted and irrigated. Fracture reduced and held in place with clamps. Bone was found to be soft. 3.5 screw was lagged from anterior to posterior by first drilling the proximal cortex. Second screw placed in similar fashion from anterior to posterior. Having done this, a 7-hole one third tubular plate was contoured to lateral aspect of distal fibula. Cortical and cancellous screws were placed.
Two SYNDESMOTIC SCREWS were also placed. Syndesmosis was found to be unstable with rotation under fluoroscopy. Screws engaged all 4 cortices. They were tightened with the foot in forced dorsiflexion. Mortise again checked and found to be stable.
Wound irrigated copiously and closed............
 
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