Hillcrest Case 7 Operative Essay

852 WordsApr 27, 20134 Pages
OPERATIVE REPORT Patient: T.J. Moreno Patient ID: 110497 DOB: 02/15 Age: 44 Sex: M Date of Admission: 10/09/2013 Date of Procedure: 10/09/2013 Admitting Physician: Patrick Keathley, MD Endocrinology Surgeon : Dr. Max Hirsch, MD Orthopedics Assistant: Markus Leroy Johnson PAC (Surgical assistant was used for soft tissue protection and retraction and also for maintaining reduction during temporary and permanent fixation use of surgical assistant was medically necessary, and to prove the safety and efficacy of the procedure.) Preoperative Diagnosis: Left hindfoot osteoarthritis. Postoperative Diagnosis: Left hindfoot osteoarthritis. Operative Procedure: 1) Triple arthrodesis . 2) Popliteal sciatic block…show more content…
The extremity was prepped and draped in the usual fashion. Extremity exsanguinated, tunicate inflated. No equinus was present. Métier incision made from the tip of the fibula to the base of the fourth metatarsal. Extensor digitorum brevis and fat pad were elevated off the inferior peroneal retinaculum. Calcaneocuboid and subtalar joints were carefully exposed, denuded of cartilage, and prepared with a 4mm osteotome for arthrodesis. The calcaneocuboid joint was exceptionally osteoarthritic. The talonevicular joint linear incision was made in line with the posterior tibial course, sharp dissection carried down through skin with blunt dissection of subcutaneous tissues. Saphenous vein was retracted in a dorsal postion, linear incision made in the periosteum. The calcaneo and the talonavicular joint were carefully exposed. Cartillage, or what was remaining of cartilage was removed. There were extreme osteoarthritic thoughout. Essentially 5%-10% of cartilage remained. The osteophytes were carefully excised with osteotome, the joint was prepared with microfracture using an osteotome on both sides of the joint. (Continued) OPERATIVE REPORT Patient: T.J. Moreno Patient ID: 110497 DOB: 02/15 Age: 44 Sex: M Page: 3 Shortly the incision made off the weight bearing surface of the posterior heel. Guide wire from the 70 cannulated

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