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Old 04-15-2010, 12:10 PM
anwalden anwalden is offline
Join Date: Apr 2007
Location: Coeur D'Alene, Idaho
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Question Tenosynovectomy of Ankle Tendons

I'm at a total loss on this one...The only tenosynovectomy code I can find is listed under arthrotomy (which was not performed). Could it be considered a tenotomy?

See Op Note:

PREOPERATIVE DIAGNOSIS: Torn peroneus brevis tendon.

POSTOPERATIVE DIAGNOSIS: Torn peroneus brevis tendon.


PROCEDURE: Repair of peroneus brevis tendon with tenosynovectomy of peroneus longus and brevis tendon.

ANESTHESIA: MAC with local anesthetic of 1%% Xylocaine and 0.25%% Marcaine with epinephrine was infiltrated in diamond block on the left lateral ankle.




PROCEDURE: The patient was transferred from the preoperative holding area to the operating room where the patient was placed on the table in the supine position, at which time, a well-padded pneumatic calf tourniquet was placed around the patient's left lower extremity and was not inflated. The extremity was prepped and draped in the usual sterile technique. The extremity was elevated and the tourniquet was inflated.

Attention was directed to the lateral aspect of the left ankle where a linear incision was made over the course of the peroneus brevis tendon 2 cm from the insertion site to just distal to the fibula. Dissection was carried down. Care was taken to retract and preserve all neurovascular vital structures and none were damaged. The tendon sheath was then incised with the peroneus brevis and noted to have significant tenosynovitic tissue involved around the entire aspect of the tendon which was pathologic. The peroneus longus was also the same way and was noted to have a linear tear. The tenosynovitis was removed. The tear was repaired with 2-0 Vicryl.

The wound was irrigated with copious amounts of sterile saline. The tendon sheath of both were not repaired. Deep tissue was closed with Vicryl and the skin with Vicryl. She was placed in a sterile dressing and transferred from the operating room to the PACU with vital signs stable and vascular status intact. No complications were encountered on the case.
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