- 2 Explain Why You Chose The Icd 10 And Cpt Code For Each Answer 3 Focus On Why You Chose The Answer And The Function 1 (27.91 KiB) Viewed 34 times
- 2 Explain Why You Chose The Icd 10 And Cpt Code For Each Answer 3 Focus On Why You Chose The Answer And The Function 2 (27.91 KiB) Viewed 34 times
- 2 Explain Why You Chose The Icd 10 And Cpt Code For Each Answer 3 Focus On Why You Chose The Answer And The Function 3 (102.19 KiB) Viewed 34 times
PREOPERATIVE DIAGNOSIS: Subtrochanteric fracture, closed, right hip. POSTOPERATIVE DIAGNOSIS: Subtrochanteric fracture, fight hip. PROCEDURE PERFORMED: Open reduction internal fixation of subtrochanteric fracture, right hip. ANESTHESIA: Spinal. FINDINGS: The patient had a displaced comminuted subtrochanteric fracture of her right hip. We were able to align this fairly well and hold this in place with a dynamic hip screw device. PROCEDURE: While under spinal anesthetic, the patient was placed in the supine position on the fracture table, where gentle traction was applied to the right leg and the left leg was abducted. We visualized the fracture using the C-arm image intensifier. We were satisfied with the position and then prepped the patient's right hip with Betadine and draped it in a sterile fashion. She was given 1 g of Kefzol intravenously preoperatively. We then created a longitudinal incision over the lateral aspect of the right hip and carried the dissection down through the subcutaneous tissue. The fascia was incised longitudinally, and we reflected the vastus lateralis anteriorly, exposing the lateral aspect of the femoral shaft. We were able to palpate the fracture and found that it was significantly displaced. We attempted to reduce this. We then drilled a 9/64-inch hole in the lateral aspect of the femoral shaft through which we advanced a guide pin into the femoral head at an angle of 135 degrees to the femoral shaft. We then passed a reamer over this and reamed to a depth of 110 mm and inserted a 100-mg lag screw into the femoral head. We attempted to position this lag screw in the center of the femoral head as best as possible as seen in both the AP and lateral views. We then attached a 135-degree four-hole side plate and secured this plate to the femoral shaft using four cortical screws. We then released the traction of the leg and inserted a compressing screw into the end of the lag screw. The resultant fixation appeared to be quite satisfactory. We again used the C-arm image intensifier to evaluate the fracture and found it to be very acceptable. We then thoroughly irrigated the area with saline and placed a Hemovac drain deep to the fascia. We then closed the fascia using 0 Vicryl and the subcutaneous tissue with 2-0 Vicryl. The skin was closed using skin staples. A sterile Xeroform dressing was applied, and the patient was then taken from the operating room in good condition breathing spontaneously. The final sponge and needle counts were correct. She will be continued on IV Kefzol for at least 24 hours.