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Thread: Revisin of lag screw & worm screw trochanteric femur fracture

  1. #1

    Default Revisin of lag screw & worm screw trochanteric femur fracture

    AAPC: Back to School
    I need some help with the following op note...

    Patient status post trochanteric femur fracture with trochanteric nail. As the fracture has compressed increasingly the screws are becoming increasingly prominent and painful. The worm screw in particular is in the subcutaneous tissues. She presents now for elective revision of hardware.

    DESCRIPTION OF PROCEDURE: I made a ½ inch incision over the prominent screw head through the old scar. I removed the worm screw easily. As I examined the construct under C-arm, the compression screw was also becoming increasingly prominent so I decided to go ahead and revise both. I did not feel comfortable leaving the just the lag screw in place with her large size. I was afraid she would have complete hardware failure. I removed the lag screw. I replaced it with a shorter lag screw and then replaced the worm screw. I examined the entire construct under C-arm. It was found to have good compression and good position. I did not perforate the articular surface. The procedure was then completed.

    Thanks in advance for your help!!
    Gail Steeves

  2. #2
    Join Date
    Apr 2007
    Greater Pittsburgh


    996.78 & V15.15 (healed traumatic fx) OR/& V54.15 (healing traumatic fx) (or stress/ or

    27244-52 for only screws being replaced, OR
    27244-22 for Revision, depending on complexity (scar tissue etc..)

    ....and was this in the global...58. There is much to consider.
    jdemar, CPC, CMA

  3. #3


    Thanks so much for your help!!!


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