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* 編碼討論平台-已結案
* 2020-11-11
診斷/手術名稱 1.right index finger total amputation with middle phalanx communicated fracture s/p heterotropi replantation from middle phalanx amputee 2.Right middle finger total amputation with fracture from proximal phalanx s/p amputation + FTSG
病歷相關內容(診斷/手術)描述 Operation
1.Replantation (RMF amputee transfer to RIF stump with vein graft) 2.right middle finger amputation 3
. FTSG

Operative Findings
1. RLF: bil N-V bundle complete severance over middel phalanx level,
FDP tendon :intact
FDS tendon :100% severance
middle phalanx lever open fracture extensore tendon rupture (100%)
2.RMF :bil N-V bundle complete severance over middel proximal level,
FDP avulsion injury: 100%
FDS intact
proximal phalanx open fracture
extensore tendon rupture (100%)

Operative Procedures
1.Under ETGA, the patient was put in supine position. The operative field was disinfected and was
draped well as usual.
2.The tourniquet was put in the right upper arm with pressure about 250 mm-Hg.
3.We excised the amputee of RIF an RMF. We shortening the bone of RMF amputee and RIF proximal
phalanx bone. We transfer RMF amputee to RIF stump .ORIF of proximal phalanx bone were fixed by two
C-wire
4. FDP tendon and FDS tendon, EDC tendon was repaired with 4-0 propylene
5. bilateral digital artery and nerve were repair with 10.0 Nylone under microscope. (one artery was repaired with vein graft)
6. Three dorsal site vein anastomosis was repair with 10.0 Nylone.
7. The r wound was irrigated with normal saline.
8.The right middle finger stump was repaired with residual skin flap with 4-0 Nylon. The right index
finger was repaired with chromic catgut and some defect covered with FTSG.
6.Short arm splint was applied.
6.Finally the patient was sent to POR under stable condition.
編碼問題說明 手術如何編碼?
最後結論 1.Replantation RMF transfer to RIF代碼0PRT07Z 。
2.Right middle finger amputation手術方式為 Detachment,請提案人與該院醫師確認截肢的位置,以利第7位碼選取。
3.FTSG從手術紀錄無法明確編碼,請提案人與該院醫師確認。