Patients who underwent open reduction internal fixation (ORIF) of a distal radius fracture were identified with CPT codes 25607, 25608, and 25609. The short-term complication rate was low.Īnkle fracture Fibular fracture Posterior malleolar fracture Posterior pilon fracture Posteromedial approach Syndesmotic injury.Ĭopyright © 2019. What is the CPT code for ORIF Distal Radius Fracture Patients who underwent nonsurgical treat- ment of a distal radius fracture were identified with CPT codes 2565. Albeit obtaining posterior malleolar fracture rigid fixation, syndesmotic instability was more prevalent than expected. Most fractures can be satisfactorily treated through a modified posteromedial approach. This article addresses pilon fracturesa specific type of fracture that occurs in the lower leg near the ankle. Posterior pilon variant fracture appears to be less common than previously reported. We report 2/25 (8%) patients with early wound problems and 7/25 (20%) with short-term complications during follow-up. Quality of reduction was assessed under CT scan in 19 patients, with 15/19 (78.9%) having anatomic reduction. Persistent syndesmotic instability was present in 11/25 (44%) patients after posterior malleolar stabilization. A modified posteromedial approach was used in 18/25 (72%) patients. The average age of patients was 42 years (22-62) 19/25 (76%) were female, and 6/25 (24%) were male. 27827 - CPT Code in category: Open treatment of fracture of weight bearing articular surface/portion of distal tibia (eg, pilon or tibial plafond), with internal fixation, when performed CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. Twenty-five patients sustained a posterior pilon fracture, accounting for 13.4% of all operatively treated ankle fractures with median follow-up of 21.7 months. Parameters measured included age, sex, type of fracture, surgical technique, anatomical reduction, and complications. Posterior pilon fracture open reduction and internal fixation. Twenty-five patients with posterior pilon fracture. It is important to use blunt dissection and the appropriate soft-tissue protection sleeves during pin placement.To review a case series of patients with posterior pilon variant fracture using a novel approach, focusing on demographic data, injury pattern, surgical results based on computed tomography (CT) scan, and short-term complications. ![]() The proximal pin should be placed in the anterior half of the tibia. Note: The course of the anterior compartment neurovascular bundle, and also the superficial peroneal nerve, should be considered during pin placement. The threaded rod of the distractor is placed posterolaterally, away from the incision. The distal pin, anterior to the axis of rotation of the talus, produces ankle joint distraction and plantarflexion, maximizing articular visualization. A second 4 mm Schanz pin is placed from lateral to medial into the tibial shaft, proximal to the intended plate. To apply the distractor laterally, a 4 mm Schanz pin is placed transversely from lateral to medial into the talar neck, through the surgical incision. Pilon fractures are fractures involving the articular weight bearing surface of the distal tibia. A temporary joint bridging external fixator is typically replaced with a distractor during definitive articular surface reduction and fixation. Return of skin wrinkles is a good sign of soft-tissue recovery.Īpplication of a distractor intraoperatively greatly assists with articular visualization and alignment of several of the major articular fragments. Definitive open reconstruction after 5-21 days: It should be delayed until the soft tissues have recovered sufficiently to allow definitive reconstruction.External fixation pins should avoid the planned future surgical approaches including the neck of the talus. Joint bridging external fixation: It should be remote from the fracture.With complex fibular fractures, it may be better not to fix the fibula in the first stage. ![]() This assists with proper positioning of the posterolateral tibial articular fragment (from the attachment of the posterior tibiofibular ligaments) and, in turn, with reduction of the talus relative to the tibial shaft. Pilon Fracture Temporay External Fixation Technique. Fibular reduction and stabilization: Accurate reduction and stabilization of the fibula re-establishes its proper length, alignment and rotation.It is generally advisable to proceed in two or more stages: (Tscherne classification, closed fracture grade 2 or 3)
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