PREOPERATIVE DIAGNOSIS:
1. Left extensor hallucis longus chronic rupture.
2. First metalarsophalangeal joint contracture.
POSTOPERATIVE DIAGNOSIS:
1. Left extensor hallucis longus chronic rupture.
2. First metatarsophalangeal joint contracture.
OPERATION PERFORMED:
1. Repair of tendon, extensor fool secondarily with free graft, extensor hallucis
brevis autograft.
2. Left foot transfer of extensor digitorum longus tendon to the second toe to the
extensor hallucis longus distal stump.
3. Capsulotomy first metatarsophalangeal joint with capsulorrhaphy of the dorsal
capsule.
DESCRIPTION OF PROCEDURE: The patient was prepped and draped in the usual sterile fashion, a 5 cm incision was made in the dorsal aspect centered over her first metatarsophalangeal joint. The extensor hallucis longus tendon was identified and found to be extremely attenuated. The extensor hallucis brevis tendon was also identified. Then performed a capsulotomy of the first metatarsophalangeal joint. The dorsal capsule was then plicated with the hallux in dorsiflexion. After this was done a shortening of the extensor hallucis longus tendon was performed. The extensor hallucis brevis tendon was then weaved into the repair using a Pulver Taft type technique. To reinforce the repair and to provide some muscle power for the hallux, the extensor digitorum longus tendon to the second toe was transferred into the repair through the same incision. A 0.062 inch K-wire was used to hold the first metatarsophalangeal joint in a dorsiflexed position.
1. Left extensor hallucis longus chronic rupture.
2. First metalarsophalangeal joint contracture.
POSTOPERATIVE DIAGNOSIS:
1. Left extensor hallucis longus chronic rupture.
2. First metatarsophalangeal joint contracture.
OPERATION PERFORMED:
1. Repair of tendon, extensor fool secondarily with free graft, extensor hallucis
brevis autograft.
2. Left foot transfer of extensor digitorum longus tendon to the second toe to the
extensor hallucis longus distal stump.
3. Capsulotomy first metatarsophalangeal joint with capsulorrhaphy of the dorsal
capsule.
DESCRIPTION OF PROCEDURE: The patient was prepped and draped in the usual sterile fashion, a 5 cm incision was made in the dorsal aspect centered over her first metatarsophalangeal joint. The extensor hallucis longus tendon was identified and found to be extremely attenuated. The extensor hallucis brevis tendon was also identified. Then performed a capsulotomy of the first metatarsophalangeal joint. The dorsal capsule was then plicated with the hallux in dorsiflexion. After this was done a shortening of the extensor hallucis longus tendon was performed. The extensor hallucis brevis tendon was then weaved into the repair using a Pulver Taft type technique. To reinforce the repair and to provide some muscle power for the hallux, the extensor digitorum longus tendon to the second toe was transferred into the repair through the same incision. A 0.062 inch K-wire was used to hold the first metatarsophalangeal joint in a dorsiflexed position.
There were no complications.
DX CODE DESCRIPTION:
1 845.19 Sprain/Strain of Foot Site NEC
2 718.47 Joint Contracture Ankle/Foot
DX CODE DESCRIPTION:
1 845.19 Sprain/Strain of Foot Site NEC
2 718.47 Joint Contracture Ankle/Foot
CPT CODE DESCRIPTION:
1 27690-LT Transfer/Transplant, Single Tendon; Superficial
2 28210-51-LT Rep Ft Extend Tend 2nd w/Gft
3 28270-51-TA Release of Foot Contracture
PX CODE DESCRIPTION:
1 83.75 Tendon Transfer/Transplantation
2 83.81 Tendon Graft
3 80.48 Division of Joint Structure Foot/Toe
If you are coding for physicians then 51 modifiers are required else if you are coding for facility then 51 modifiers are not required.
3 80.48 Division of Joint Structure Foot/Toe
If you are coding for physicians then 51 modifiers are required else if you are coding for facility then 51 modifiers are not required.
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