What is scaphoid fixation?

Scaphoid Fracture Open Reduction and Internal Fixation (ORIF) is a procedure that stabilizes a fractured scaphoid bone with screw fixation. The scaphoid is an important carpal bone of the wrist, which is critical in coordinating motion of the other carpal bones and the radius.

What is the CPT code for repair of nonunion of carpal bone?

CPT code 25431 (Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) (includes obtaining graft and necessary fixation), each bone) states in its definition the instructions “includes obtaining graft and necessary fixation).

How long does a scaphoid surgery take?

Technique: The surgeon makes a tiny incision in the skin (1mm to 2mm long) and places a screw in the bone, across the fracture line, with the entire procedure usually being completed in less than an hour.

When does a scaphoid fracture need surgery?

Surgical treatment is indicated for non-displaced scaphoid fractures which have not healed after 6 weeks of splinting. It is also necessary for unstable scaphoid fractures and displaced scaphoid fractures.

What is the difference between CPT 20900 and 20902?

20900 states “Minor, small, like a button or dowel” and 20902 states “Major, large, larger than a button or dowel”.

When to use Percutaneous Fixation for scaphoid fractures?

Percutaneous fixation is largely indicated for undisplaced or minimally displaced fractures of the waist of the scaphoid. Hyperextension and ulnar deviation of the wrist will facilitate any necessary reduction of the fracture.

How do you fix a screw in a scaphoid?

Use Ringer lactate solution to cool the drill bit, in order to minimize thermal injury. Check the position of the tip of the drill bit using image intensification. Tap the drill hole manually if not using self-tapping screws. Insert the screw manually over the guide wire.

Where is the insertion point for a scaphoid screw?

The insertion point is on the distal surface of the scaphoid tubercle, at the edge of the scaphotrapezial joint. The threaded guide wire is inserted at the confirmed entry point through a drill guide. If no drill guide is available, use a protective sleeve.

How is a closed reduction screw fixation done?

Here’s the op note: PROCEDURE IN DETAIL: The patient was placed in the supine position with establishment of general endotracheal anesthesia. The right lower extremity was prepped and draped in a sterile fashion. The C-arm was used to visualize the fracture and the tenaculum clamp was used to reduce the fracture.