Wiki Weil Osteotomy

Create Wiki
W

wsoler

Contributor
Messages
13
Location
Stony Brook, NY
Best answers
0
What is a Weil Osteotomy and how do you code it? The patient has a dislocated 2nd metatarsal due to Hallux Valgus of the left foot. The procedure done was Austin osteotomy of the hallux valgus with Weil osteotomy of the 2nd metatarsal. I coded 28296-LT with 28308-LT. I'm not sure if that's correct.:confused: If anyone could provide some guidance that would be greatly appreciated.:)
 
What about:
PROCEDURES:

  1. First metatarsocuneiform arthrodesis, right foot.
  2. Akin osteotomy, right foot.
  3. Second metatarsal Weil osteotomy, right foot.
marker was used to plan a linear incision over the dorsal aspect of the 1st tarsometatarsal joint as well as the first metatarsophalangeal joint and on the dorsal aspect of the 2nd metatarsal. A 15 blade was used to make the incisions down to subcuticular tissue. Electrocautery was used for hemostasis of small bleeders. Care was taken to protect and retract vital neurovascular and tendinous structures throughout the case. Attention was directed to the first metatarsophalangeal joint. A 15 blade was used to free soft tissue and periosteum from the metatarsal head. A sagittal saw was used to remove the medial bony eminence off the 1st metatarsal head.



Attention was directed back to the 1st metatarsocuneiform joint. A 15 blade was used to free soft tissue and periosteum off the joint. A sagittal saw was used to remove the articular cartilage from the base of the first metatarsal as well as the medial cuneiform. The site was irrigated with sterile saline. A drill bit was used for fenestration across the 1st metatarsocuneiform joint. The joint was temporarily held in place using 2 crossing K-wires. Intraoperative fluoroscopy was used to confirm correct alignment and appropriate reduction of the hallux abductovalgus. Two cannulated screws were placed over the K-wires for permanent fixation, following AO technique.



Attention was directed back to the 1st metatarsophalangeal joint, and the incision was carried distally, exposing the proximal phalanx. A sagittal saw was used to make a medially based closing wedge osteotomy within the proximal phalanx. This was reduced, and a 9 mm Synthes staple was placed across the osteotomy site.

​

Attention was directed to the 2nd metatarsal, and a 15 blade was used to make an incision over the metatarsal head. A 15 blade was used for further dissection, and soft tissue was freed from the metatarsal head. A sagittal saw was used to make an oblique osteotomy through the metatarsal. The capital fragment was shifted proximally and permanently fixated using a Synthes snap-off screw. A rongeur was used to remove bony overhang. Final x-rays were obtained to ensure reduction of the hallux abductovalgus, realignment of the sesamoids, and proper placement of all hardware. The incisions were irrigated with copious amounts of normal sterile saline. The deep tissue was closed using 3-0 Vicryl, subcutaneous closure with 3-0 Vicryl, and skin was reapproximated using 4-0 Monocryl
 
You must log in or register to reply here.
Top