![]() ![]() Same as type III with associated elbow dislocation.If distal ulnar instability is present, it is best to pin the ulna to the radius with the forearm in supination.I would pair the 24999 with 24566: Percutaneous skeletal fixation of humeral epicondylar. There is none that addresses percutaneous pinning of the Olecranon fracture. Either replacement or reconstruction is indicated in these cases. Answer: You should report 24666 ( Open treatment of radial head or neck fracture, with or without internal fixation or radial head excision with radial head prosthetic replacement ), because this code includes the fracture treatment, the excision, and the radial head prosthetic replacement. Having reviewed the various codes for treatment of the injuries and procedures as you describe them, I believe you are correct in your choices. Excision alone is contraindicated when either medial collateral ligament or interosseous membrane disruption is present.Treatment: Radial Head Excision (Herbertsson P, JBJS 2004 86A:1925) vs Radial Head Replacement (Moro JK, JBJS 2001 83A:1201).Have radial head replacement available.Determination of Type II or Type III fracture type can often only be made intraoperatively.82% of patients are asymptomatic at 19yrs with non-op treatment (Akesson T, JBJS 2006 88A:1909). Commonly Used CPT Codes CPT Code: 25565Closed treatment of radial and ulnar shaft fractures with manipulation CPT Code: 25605Closed treatment of distal radial fracture (e.g. CPT Codes: Common Procedures : 23472: Total Shoulder Arthroplasty: Arthroplasty, glenohumeral joint total shoulder (glenoid and proximal humeral replacement (eg, total shoulder)).IF mechanical block to motion, or joint instability or displacement >3mm= Radial Head Fracture ORIF if stable, <3mm displaced with full ROM nonop treatment indicated. Principles For elbow dislocations with fracture of the radial head with or without fracture of the coronoid the following principles apply: The risk of re-dislocation is minimized by fixation or replacement of the radial head, reattachment of the lateral collateral ligament to the lateral epicondyle, and if need, coronoid fracture fixation. ![]() Treatment: examination under anesthesia.CPT code information is copyright by the AMA. 518, FX, 24665, Open treatment of radial head or neck fracture. ![]() ![]()
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