Hi there! Are there any possible wrist tendon experts that have come across this procedure.
Pt has ECU subluxation
The surgeon makes an incision down to the 6th dorsal compartment and dictates that it is slightly loose. THe ECU would mobilize in this, however, the ECU was not torn out of the sheath itself. This was then elevated subperiosteally from the ulnar side in order to keep the ECU within its subsheath. The tendon through the subsheath did not show any obvious tearing. At this point, with superiosteal dissection this allowed the facilitation of the ulnar groove, this was flattened slightly. A bur was used in order to deepen this to about 2mm. At which point placing a Freer in here I was able to appreciate a healthy concavity that would hold the ECU. The ECU was placed into the groove that was graded and held with a pickup and then bringing the wrist through ROM, pronation, supination multiple times there was no sublutation what was appreciated.
A mini Mitek anchor was place dont he ulnar border where the initial inciions had been made on the ECU sheath and then a second suture anchor just proximally. Both anchors were firm and stable. Then a mattress suture was placed in the subsheath as well incorporaing the extensor retinaculum of the 6th compartment and this located the ECU within the groove. This second anchor also had a mattress suture placed again incorporating both layers. These sutures were then placed in a running fashion proximally and distally to both acnchors creating a stable sheath.
The closest procedure I see is 25275 (no graft involved) possibly a comparable to unlisted.
Thank you in advance
Pt has ECU subluxation
The surgeon makes an incision down to the 6th dorsal compartment and dictates that it is slightly loose. THe ECU would mobilize in this, however, the ECU was not torn out of the sheath itself. This was then elevated subperiosteally from the ulnar side in order to keep the ECU within its subsheath. The tendon through the subsheath did not show any obvious tearing. At this point, with superiosteal dissection this allowed the facilitation of the ulnar groove, this was flattened slightly. A bur was used in order to deepen this to about 2mm. At which point placing a Freer in here I was able to appreciate a healthy concavity that would hold the ECU. The ECU was placed into the groove that was graded and held with a pickup and then bringing the wrist through ROM, pronation, supination multiple times there was no sublutation what was appreciated.
A mini Mitek anchor was place dont he ulnar border where the initial inciions had been made on the ECU sheath and then a second suture anchor just proximally. Both anchors were firm and stable. Then a mattress suture was placed in the subsheath as well incorporaing the extensor retinaculum of the 6th compartment and this located the ECU within the groove. This second anchor also had a mattress suture placed again incorporating both layers. These sutures were then placed in a running fashion proximally and distally to both acnchors creating a stable sheath.
The closest procedure I see is 25275 (no graft involved) possibly a comparable to unlisted.
Thank you in advance