Practicode: Practicode I (1-100) Final
Exam Questions with Actual Answers
2026 Updated.
CaseID: OPD6921
Primary Diagnosis: Z41.1
Secondary Diagnosis: N64.81, N63.22, Q83.1, E65, L98.7
CPT: 15830, 19316-50, 19120-LT, 15877 - Answer MEDICAL RECORD
OPERATIVE NOTEPHYSICIAN:PREOPERATIVE DIAGNOSES:1. Localized abdominal adiposity2. Left
axillary glandular tissue.3. Bilateral breast ptosis.POSTOPERATIVE DIAGNOSES:1. Localized
abdominal adiposity.2. Left axillary glandular tissue.3. Bilateral breast ptosis.4. Left breast lump
upper inner quadrantOPERATIVE PROCEDURE:1. Bilateral mastopexy.2. Bilateral axillary and
chest wall suction-assisted lipectomy.3. Excision of left breast lump upper inner quadrant.4.
Abdominoplasty with upper abdomen and flank liposuction.SURGEON:ANESTHESIA:
General.COMPLICATIONS: None.INDICATIONS: Ms. Smith is a female, who presented to clinic
with significant abdominal dermatolipodystrophy, breast ptosis, and redundant left axillary
tissue. She desired body contouring surgery. I recommended mastopexy with abdominoplasty,
as well as liposuction of her bilateral axilla, and upper abdomen, as well as flanks. She also had
redundant left axillary tissue, which was significant with ectopic or accessory breast glandular
tissue, which I recommended direct excision. The patient agreed and wished to proceed with
the above-mentioned procedures.DESCRIPTION OF PROCEDURE: The patient was brought to the
operating room, where she was placed in the supine position. She was placed under general
anesthesia. The patient's breasts and abdomen were sterilely prepped and draped in the usual
fashion. She was marked in the preoperative holding area for bilateral mastopexy and
abdominoplasty. I first started with mastopexy. On the patient's right, I traced out the patient's
nipple areolar margin with a 42-mm cookie cutter. This was incised partial-thickness through the
skin with a 10-blade scalpel. The skin incisions, which had been planned in the preoperative
holding area, were then incised partially through the skin thickness with a 10-blade scalpel.
CaseID: OPD6922
Primary Diagnosis: I87.2
Secondary Diagnosis: L97.411, L97.421
CPT: 15120 - Answer DATE OF OPERATION: 1/01/20XXPREOPERATIVE DIAGNOSIS:
NONHEALING VENOUS STASIS ULCERS, BILATERAL LOWER EXTREMITY.PROCEDURES: BILATERAL
LOWER EXTREMITY SPLIT-THICKNESS SKIN GRAFTINGPOSTOPERATIVE DIAGNOSIS: CHRONIC,
VENOUS STASIS ULCERS BILATERAL LOWER EXTREMITY.SURGEON:ANESTHESIA:
SPINAL.ESTIMATED BLOOD LOSS: MINIMAL.COMPLICATIONS: NONE.INDICATIONS: The patient is
a male with chronic venous insufficiency and bilateral lower extremity venous stasis ulcers
limited to breakdown of skin.PROCEDURE: The patient was brought to the operating room and
placed on the OR table in the sitting position. Spinal anesthesia was administered by
anesthesiologist. The patient was placed supine and both lower extremities were prepped and
draped for sterile procedure.We directed our attention to the left upper thigh where split-
thickness graft was harvested with 0.0020-inch thickness. At this point, graft was meshed with
the ratio of 1:1.5 and placed on both venous stasis ulcers on the medial aspect of the left heel
,and plantar midfoot and lateral aspect of the right heel and plantar midfoot and held in place
using surgical staple device.Xeroform was placed on both wounds. VAC sponges were applied on
both wounds. No leakage noted from the sponge site of VAC device and tubing was connected
to the suction machine.The patient tolerated the procedure well. He was wide-awake at the end
of the procedure and safely transported to the recovery room for further
management.Electronically signed by 1/1/20XX
CaseID: OPD6924
Primary Diagnosis: T84.84XA
CPT: 20680 - Answer MEDICAL RECORD
PREOPERATIVE DIAGNOSIS: REMOVAL OF HARDWARE DUE TO PAIN STATUS POST-OP-KNOWLES
PIN (X 3) FIXATION OF RIGHT HIPPROCEDURES: REMOVAL OF KNOWLES PIN X 3; RIGHT
HIP.POSTOPERATIVE DIAGNOSIS: REMOVAL OF HARDWARE DUE TO PAIN/ STATUS POST-OP-
KNOWLES PIN (X 3) FIXATION OF RIGHT HIPSURGEON:ANESTHESIA:
GENERAL.ANESTHESIOLOGIST:PROCEDURE: After adequate induction with general anesthesia
and the patient on the fracture table, the right lower extremity was stabilized in neutral
rotation. Preliminary views were taken with the image intensifier and the AP and lateral plains
demonstrating the presence of three Knowles pins in the right hip. The right hip was scrubbed,
prepped with Betadine and draped in the usual manner for lateral approach surgery.The
location of the Knowles pins was determined with the C-arm and a 3-inch incision was made
through previously healed surgical scar. The incision was brought down through subcutaneous
tissue, fascia lata and proximal vastus lateralis. As determined by the image intensifier views, a
considerable amount of bone had grown over and covered the heads of the Knowles ends.
Thus, after appropriate soft tissue dissection and hemostasis, a curved osteotome and mallet
was utilized to unroof and expose the squared heads of the Knowles pins.The Knowles pins
screw heads were found to be straight alignment with impingement of the distal two (2) pins
upon one another. Bony in growth was removed from the periphery of the pin heads utilizing a
small straight osteotome and mallet. The screws were removed in their entirety utilizing a vice
grip. After complete hardware removal, the bone site was examined and there was no evidence
of bone defect propagation nor fracture. The operative site was repeatedly irrigated with saline
solution.The vastus lateralis and fascia lata were repaired with figure
CaseID: OPD6929
Primary Diagnosis: S82.301D, S82.302D
E/M Level: 20680-RT, 20694-RT - Answer MEDICAL RECORD
SEX: MALE Age: 62DATE OF OPERATION: 1/1/20XXPREOPERATIVE DIAGNOSIS: RIGHT LOWER
END TIBIA STATUS POST ORIF WITH RETAINED SYNDESMOTIC SCREW, LEFT LOWER END TIBIA
STATUS POST EXTERNAL FIXATION WITH RETAINED HARDWARE.PROCEDURES: RIGHT LOWER
END TIBIA REMOVAL OF SYNDESMOTIC SCREWS, LEFT LOWER END TIBIA REMOVAL OF
EXTERNAL FIXATOR.POSTOPERATIVE DIAGNOSIS: RIGHT LOWER END TIBIA STATUS POST ORIF
WITH RETAINED SYNDESMOTIC SCREW AND LEFT LOWER END TIBIA STATUS POST EXTERNAL
FIXATION WITH RETAINED HARDWARE.SURGEON: Stephanie Andrews MDANESTHESIA: LOCAL
WITH IV SEDATION. (MAC)ESTIMATE BLOOD LOSS: 20 CC.TOURNIQUET TIME:
NONE.ANTIBIOTICS: 1 GM OF ANCEF.COMPLICATIONS: NONE.INDICATIONS: The patient is a
male who sustained a left lower end tibia fracture and had external fixation and a right lower
end tibia ORIF with syndesmotic screws. He had healed the syndesmotic area and was
,complaining of the external fixator and requesting removal.Options, risks and benefits were
discussed with the patient. He agreed with removal of the external fixator and of the
syndesmotic screws.PROCEDURE: The patient was brought to the operating room and the right
lower extremity was prepped and draped in sterile fashion and he was injected with a 50:50
mixture of 1% lidocaine with epinephrine and 0.25% Marcaine along the area where the
syndesmotic screws were located.A longitudinal incision was made through the previous
incision and the screws were viewed and removed without difficulty. The wound was irrigated
out with sterile saline and the skin was closed with interrupted 3-0 nylon sutures. The left tibia
external fixator pins were removed and sterilely dressed in this area.The patient was then taken
to the recovery room in stable condition.Electronically signed by 1/1/20XX
CaseID: OPD6937
Primary Diagnosis: M75.121
Secondary Diagnosis: S46.211A
CPT: 23410-RT and 29824-RT - Answer Age: 71SEX: FEMALEDate of Service: 1/1/20XXService
Department: Orthopedic Group GeneralProvider:OPERATIVE NOTE:OPERATIVE DIAGNOSIS:
Right shoulder partial biceps tendon tearing with full-thickness supraspinatus tear 1 cmNAME
OF PROCEDURE: Right shoulder examination under anesthesia, arthroscopy, biceps tendon
debridement, Open rotator cuff repairSURGEON:ANESTHESIA: General with scalene
block.ESTIMATED BLOOD LOSS: Minimal.COMPLICATIONS: None.DESCRIPTION OF PROCEDURE:
With the patient in a beach-chair position under endotracheal intubation and general
anesthesia, the right shoulder was examined. It had a full range of motion. Ligaments were
stable. The right shoulder was then prepped and draped free in the usual manner. A posterior
portal was established after insufflating the joint with 50 mL of sterile saline.Within the shoulder
joint we found normal cartilage on both articular surfaces. The interior recess was clear. We
established a portal anteriorly in the interval above the subscapularis tendon. The subscapularis
was intact. There was obvious partial degeneration and tearing the biceps tendon. We used a
shaver and debrided this back to good stable tissue. Superior labrum was attached normally.
There was a full-thickness tear in the supraspinatus tendon.We removed the instruments and
placed the arthroscope into the subacromial space. Here we identified the superior surface of
the tear and found its length to be about 1 to 1.5 cm. We established a lateral portal. We
performed bursectomy and debrided the undersurface of the acromion of soft tissue. We
performed an acromioplasty. We then took out the anterior hook of the acromion and the
anterior-inferior half of the acromion as far back as the posterior edge of the distal clavicle. We
then entered the AC joint through the anterior portal and performed a distal clavicu
CaseID: OPD6942
Primary Diagnosis: S52.572A
CPT: 25609-LT - Answer Age 72 Sex: MALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Left distal radius intraarticular
fracture.POSTOPERATIVE DIAGNOSIS: Left distal radius intraarticular fracture.NAME OF
PROCEDURE:1. Open reduction internal fixation of left distal radius intraarticular fracture.2.
Intraoperative use of fluoroscopy.SURGEON: Dr.XINDICATIONS: The patient is a male with a
comminuted fracture of his distal intraarticular radius. He presents at this time for open
reduction internal fixation.DESCRIPTION OF PROCEDURE: The patient was taken to the
operating room where he was first given an axillary block anesthetic. Next, his forearm, arm and
hand were prepped and draped in normal sterile circumferential fashion. Next, his arm was
, elevated, exsanguinated with an Esmarch bandage, tourniquet inflated to 250 mmHg. Next, an
incision was made over his volar radial forearm with a 15 blade. Next, pickups and tenotomy
scissors were used to dissect through the subcutaneous tissue down to the antebrachial fascia.
Next, the antebrachial fascia was opened between the flexor carpi radialis tendon and the radial
artery and its vena comitantes. I then developed the plane between these 2 structures using the
pickups and tenotomy scissors right down to the volar surface of the radius and the pronator
quadratus. Next, I incised the pronator quadratus and reflected the pronator quadratus off the
volar surface of the radius from proximal to distal and thereby exposed the fracture. The
fracture was comminuted. There were several fragments: there was a large ulnar piece, there
was an interarticular extension particularly into the DRUJ, there was a dorsal fragment that was
out of the place as well, there were at least 4 or more fragments. In order to reduce this, I had
to flex the wrist and distract it. Once I
CaseID: OPD6954
Primary Diagnosis: S83.231A, S83.251A, M94.261
CPT: 29880-RT - Answer MEDICAL RECORD
OPERATIVE NOTE
AGE:56 Sex: FEMALEDOS: 1/1/20XXPREOPERATIVE DIAGNOSES: Torn medial meniscus right
knee.POSTOPERATIVE DIAGNOSES: Complex Tear medial meniscus right knee plus Bucket
Handle Tear of lateral meniscus and grade 4 chondrosis medial femoral condyle, medial tibial
plateau, and retropatellar surface.OPERATIVE PROCEDURES: Medial and lateral meniscectomies
and chondroplasty of medial compartment and patellofemoral joint.SURGEON: Dr.
MDANESTHESIA: General.BRIEF SUMMARY: This lady has had progressive problems with her
right knee injury several months ago. She underwent arthroscopy for a torn meniscus on the
opposite side one month ago and has had a good result. Now, her right knee is giving her most
difficulty. MRI scan was performed, which shows complex tear of the posterior horn medial
meniscus and she is admitted for meniscectomy.FINDINGS OF SURGERY: Complex tear posterior
horn medial meniscus involving flap and horizontal cleavage component, one-half of the
posterior horn was resected including the inferior flap of the cleavage. She had grade 4 changes
in an area of 3 x 3 cm on the medial femoral and on the medial tibial plateau 1 x 3 mm grade 4,
also retropatellar surface grade 4 changes and an area of 2 x 2 cm. Chondroplasty performed of
medial compartment of the patellofemoral joint. There was a bucket handle tear anterior horn
lateral meniscus. Partial meniscectomy performed.DESCRIPTION OF PROCEDURE: The patient
was anesthetized, placed supine, and given general anesthesia. The right lower extremity was
placed in a leg holder, prepped and draped in a normal sterile fashion, exsanguinated with an
Esmarch. Tourniquet inflated to 350 mmHg. The arthroscope was inserted through the
inferolateral portal and working portals accessory lateral and medial. The above findings were
noted. Motorized shaver
CaseID: OPD6956
Primary Diagnosis: S83.252A, M94.262
Secondary Diagnosis: Z53.33
CPT: 27403-LT, 29877-LT - Answer MEDICAL RECORD
OPERATIVE NOTEAGE: 66 Sex: FEMALEDOS 1/1/20XXPHYSICIAN: Dr.PREOPERATIVE DIAGNOSIS:
Left knee meniscal tear.POSTOPERATIVE DIAGNOSIS: Left knee Lateral Bucket Handle Meniscal
Exam Questions with Actual Answers
2026 Updated.
CaseID: OPD6921
Primary Diagnosis: Z41.1
Secondary Diagnosis: N64.81, N63.22, Q83.1, E65, L98.7
CPT: 15830, 19316-50, 19120-LT, 15877 - Answer MEDICAL RECORD
OPERATIVE NOTEPHYSICIAN:PREOPERATIVE DIAGNOSES:1. Localized abdominal adiposity2. Left
axillary glandular tissue.3. Bilateral breast ptosis.POSTOPERATIVE DIAGNOSES:1. Localized
abdominal adiposity.2. Left axillary glandular tissue.3. Bilateral breast ptosis.4. Left breast lump
upper inner quadrantOPERATIVE PROCEDURE:1. Bilateral mastopexy.2. Bilateral axillary and
chest wall suction-assisted lipectomy.3. Excision of left breast lump upper inner quadrant.4.
Abdominoplasty with upper abdomen and flank liposuction.SURGEON:ANESTHESIA:
General.COMPLICATIONS: None.INDICATIONS: Ms. Smith is a female, who presented to clinic
with significant abdominal dermatolipodystrophy, breast ptosis, and redundant left axillary
tissue. She desired body contouring surgery. I recommended mastopexy with abdominoplasty,
as well as liposuction of her bilateral axilla, and upper abdomen, as well as flanks. She also had
redundant left axillary tissue, which was significant with ectopic or accessory breast glandular
tissue, which I recommended direct excision. The patient agreed and wished to proceed with
the above-mentioned procedures.DESCRIPTION OF PROCEDURE: The patient was brought to the
operating room, where she was placed in the supine position. She was placed under general
anesthesia. The patient's breasts and abdomen were sterilely prepped and draped in the usual
fashion. She was marked in the preoperative holding area for bilateral mastopexy and
abdominoplasty. I first started with mastopexy. On the patient's right, I traced out the patient's
nipple areolar margin with a 42-mm cookie cutter. This was incised partial-thickness through the
skin with a 10-blade scalpel. The skin incisions, which had been planned in the preoperative
holding area, were then incised partially through the skin thickness with a 10-blade scalpel.
CaseID: OPD6922
Primary Diagnosis: I87.2
Secondary Diagnosis: L97.411, L97.421
CPT: 15120 - Answer DATE OF OPERATION: 1/01/20XXPREOPERATIVE DIAGNOSIS:
NONHEALING VENOUS STASIS ULCERS, BILATERAL LOWER EXTREMITY.PROCEDURES: BILATERAL
LOWER EXTREMITY SPLIT-THICKNESS SKIN GRAFTINGPOSTOPERATIVE DIAGNOSIS: CHRONIC,
VENOUS STASIS ULCERS BILATERAL LOWER EXTREMITY.SURGEON:ANESTHESIA:
SPINAL.ESTIMATED BLOOD LOSS: MINIMAL.COMPLICATIONS: NONE.INDICATIONS: The patient is
a male with chronic venous insufficiency and bilateral lower extremity venous stasis ulcers
limited to breakdown of skin.PROCEDURE: The patient was brought to the operating room and
placed on the OR table in the sitting position. Spinal anesthesia was administered by
anesthesiologist. The patient was placed supine and both lower extremities were prepped and
draped for sterile procedure.We directed our attention to the left upper thigh where split-
thickness graft was harvested with 0.0020-inch thickness. At this point, graft was meshed with
the ratio of 1:1.5 and placed on both venous stasis ulcers on the medial aspect of the left heel
,and plantar midfoot and lateral aspect of the right heel and plantar midfoot and held in place
using surgical staple device.Xeroform was placed on both wounds. VAC sponges were applied on
both wounds. No leakage noted from the sponge site of VAC device and tubing was connected
to the suction machine.The patient tolerated the procedure well. He was wide-awake at the end
of the procedure and safely transported to the recovery room for further
management.Electronically signed by 1/1/20XX
CaseID: OPD6924
Primary Diagnosis: T84.84XA
CPT: 20680 - Answer MEDICAL RECORD
PREOPERATIVE DIAGNOSIS: REMOVAL OF HARDWARE DUE TO PAIN STATUS POST-OP-KNOWLES
PIN (X 3) FIXATION OF RIGHT HIPPROCEDURES: REMOVAL OF KNOWLES PIN X 3; RIGHT
HIP.POSTOPERATIVE DIAGNOSIS: REMOVAL OF HARDWARE DUE TO PAIN/ STATUS POST-OP-
KNOWLES PIN (X 3) FIXATION OF RIGHT HIPSURGEON:ANESTHESIA:
GENERAL.ANESTHESIOLOGIST:PROCEDURE: After adequate induction with general anesthesia
and the patient on the fracture table, the right lower extremity was stabilized in neutral
rotation. Preliminary views were taken with the image intensifier and the AP and lateral plains
demonstrating the presence of three Knowles pins in the right hip. The right hip was scrubbed,
prepped with Betadine and draped in the usual manner for lateral approach surgery.The
location of the Knowles pins was determined with the C-arm and a 3-inch incision was made
through previously healed surgical scar. The incision was brought down through subcutaneous
tissue, fascia lata and proximal vastus lateralis. As determined by the image intensifier views, a
considerable amount of bone had grown over and covered the heads of the Knowles ends.
Thus, after appropriate soft tissue dissection and hemostasis, a curved osteotome and mallet
was utilized to unroof and expose the squared heads of the Knowles pins.The Knowles pins
screw heads were found to be straight alignment with impingement of the distal two (2) pins
upon one another. Bony in growth was removed from the periphery of the pin heads utilizing a
small straight osteotome and mallet. The screws were removed in their entirety utilizing a vice
grip. After complete hardware removal, the bone site was examined and there was no evidence
of bone defect propagation nor fracture. The operative site was repeatedly irrigated with saline
solution.The vastus lateralis and fascia lata were repaired with figure
CaseID: OPD6929
Primary Diagnosis: S82.301D, S82.302D
E/M Level: 20680-RT, 20694-RT - Answer MEDICAL RECORD
SEX: MALE Age: 62DATE OF OPERATION: 1/1/20XXPREOPERATIVE DIAGNOSIS: RIGHT LOWER
END TIBIA STATUS POST ORIF WITH RETAINED SYNDESMOTIC SCREW, LEFT LOWER END TIBIA
STATUS POST EXTERNAL FIXATION WITH RETAINED HARDWARE.PROCEDURES: RIGHT LOWER
END TIBIA REMOVAL OF SYNDESMOTIC SCREWS, LEFT LOWER END TIBIA REMOVAL OF
EXTERNAL FIXATOR.POSTOPERATIVE DIAGNOSIS: RIGHT LOWER END TIBIA STATUS POST ORIF
WITH RETAINED SYNDESMOTIC SCREW AND LEFT LOWER END TIBIA STATUS POST EXTERNAL
FIXATION WITH RETAINED HARDWARE.SURGEON: Stephanie Andrews MDANESTHESIA: LOCAL
WITH IV SEDATION. (MAC)ESTIMATE BLOOD LOSS: 20 CC.TOURNIQUET TIME:
NONE.ANTIBIOTICS: 1 GM OF ANCEF.COMPLICATIONS: NONE.INDICATIONS: The patient is a
male who sustained a left lower end tibia fracture and had external fixation and a right lower
end tibia ORIF with syndesmotic screws. He had healed the syndesmotic area and was
,complaining of the external fixator and requesting removal.Options, risks and benefits were
discussed with the patient. He agreed with removal of the external fixator and of the
syndesmotic screws.PROCEDURE: The patient was brought to the operating room and the right
lower extremity was prepped and draped in sterile fashion and he was injected with a 50:50
mixture of 1% lidocaine with epinephrine and 0.25% Marcaine along the area where the
syndesmotic screws were located.A longitudinal incision was made through the previous
incision and the screws were viewed and removed without difficulty. The wound was irrigated
out with sterile saline and the skin was closed with interrupted 3-0 nylon sutures. The left tibia
external fixator pins were removed and sterilely dressed in this area.The patient was then taken
to the recovery room in stable condition.Electronically signed by 1/1/20XX
CaseID: OPD6937
Primary Diagnosis: M75.121
Secondary Diagnosis: S46.211A
CPT: 23410-RT and 29824-RT - Answer Age: 71SEX: FEMALEDate of Service: 1/1/20XXService
Department: Orthopedic Group GeneralProvider:OPERATIVE NOTE:OPERATIVE DIAGNOSIS:
Right shoulder partial biceps tendon tearing with full-thickness supraspinatus tear 1 cmNAME
OF PROCEDURE: Right shoulder examination under anesthesia, arthroscopy, biceps tendon
debridement, Open rotator cuff repairSURGEON:ANESTHESIA: General with scalene
block.ESTIMATED BLOOD LOSS: Minimal.COMPLICATIONS: None.DESCRIPTION OF PROCEDURE:
With the patient in a beach-chair position under endotracheal intubation and general
anesthesia, the right shoulder was examined. It had a full range of motion. Ligaments were
stable. The right shoulder was then prepped and draped free in the usual manner. A posterior
portal was established after insufflating the joint with 50 mL of sterile saline.Within the shoulder
joint we found normal cartilage on both articular surfaces. The interior recess was clear. We
established a portal anteriorly in the interval above the subscapularis tendon. The subscapularis
was intact. There was obvious partial degeneration and tearing the biceps tendon. We used a
shaver and debrided this back to good stable tissue. Superior labrum was attached normally.
There was a full-thickness tear in the supraspinatus tendon.We removed the instruments and
placed the arthroscope into the subacromial space. Here we identified the superior surface of
the tear and found its length to be about 1 to 1.5 cm. We established a lateral portal. We
performed bursectomy and debrided the undersurface of the acromion of soft tissue. We
performed an acromioplasty. We then took out the anterior hook of the acromion and the
anterior-inferior half of the acromion as far back as the posterior edge of the distal clavicle. We
then entered the AC joint through the anterior portal and performed a distal clavicu
CaseID: OPD6942
Primary Diagnosis: S52.572A
CPT: 25609-LT - Answer Age 72 Sex: MALEDate of Service: 1/1/20XXService Department:
Orthopedic Group GeneralPREOPERATIVE DIAGNOSIS: Left distal radius intraarticular
fracture.POSTOPERATIVE DIAGNOSIS: Left distal radius intraarticular fracture.NAME OF
PROCEDURE:1. Open reduction internal fixation of left distal radius intraarticular fracture.2.
Intraoperative use of fluoroscopy.SURGEON: Dr.XINDICATIONS: The patient is a male with a
comminuted fracture of his distal intraarticular radius. He presents at this time for open
reduction internal fixation.DESCRIPTION OF PROCEDURE: The patient was taken to the
operating room where he was first given an axillary block anesthetic. Next, his forearm, arm and
hand were prepped and draped in normal sterile circumferential fashion. Next, his arm was
, elevated, exsanguinated with an Esmarch bandage, tourniquet inflated to 250 mmHg. Next, an
incision was made over his volar radial forearm with a 15 blade. Next, pickups and tenotomy
scissors were used to dissect through the subcutaneous tissue down to the antebrachial fascia.
Next, the antebrachial fascia was opened between the flexor carpi radialis tendon and the radial
artery and its vena comitantes. I then developed the plane between these 2 structures using the
pickups and tenotomy scissors right down to the volar surface of the radius and the pronator
quadratus. Next, I incised the pronator quadratus and reflected the pronator quadratus off the
volar surface of the radius from proximal to distal and thereby exposed the fracture. The
fracture was comminuted. There were several fragments: there was a large ulnar piece, there
was an interarticular extension particularly into the DRUJ, there was a dorsal fragment that was
out of the place as well, there were at least 4 or more fragments. In order to reduce this, I had
to flex the wrist and distract it. Once I
CaseID: OPD6954
Primary Diagnosis: S83.231A, S83.251A, M94.261
CPT: 29880-RT - Answer MEDICAL RECORD
OPERATIVE NOTE
AGE:56 Sex: FEMALEDOS: 1/1/20XXPREOPERATIVE DIAGNOSES: Torn medial meniscus right
knee.POSTOPERATIVE DIAGNOSES: Complex Tear medial meniscus right knee plus Bucket
Handle Tear of lateral meniscus and grade 4 chondrosis medial femoral condyle, medial tibial
plateau, and retropatellar surface.OPERATIVE PROCEDURES: Medial and lateral meniscectomies
and chondroplasty of medial compartment and patellofemoral joint.SURGEON: Dr.
MDANESTHESIA: General.BRIEF SUMMARY: This lady has had progressive problems with her
right knee injury several months ago. She underwent arthroscopy for a torn meniscus on the
opposite side one month ago and has had a good result. Now, her right knee is giving her most
difficulty. MRI scan was performed, which shows complex tear of the posterior horn medial
meniscus and she is admitted for meniscectomy.FINDINGS OF SURGERY: Complex tear posterior
horn medial meniscus involving flap and horizontal cleavage component, one-half of the
posterior horn was resected including the inferior flap of the cleavage. She had grade 4 changes
in an area of 3 x 3 cm on the medial femoral and on the medial tibial plateau 1 x 3 mm grade 4,
also retropatellar surface grade 4 changes and an area of 2 x 2 cm. Chondroplasty performed of
medial compartment of the patellofemoral joint. There was a bucket handle tear anterior horn
lateral meniscus. Partial meniscectomy performed.DESCRIPTION OF PROCEDURE: The patient
was anesthetized, placed supine, and given general anesthesia. The right lower extremity was
placed in a leg holder, prepped and draped in a normal sterile fashion, exsanguinated with an
Esmarch. Tourniquet inflated to 350 mmHg. The arthroscope was inserted through the
inferolateral portal and working portals accessory lateral and medial. The above findings were
noted. Motorized shaver
CaseID: OPD6956
Primary Diagnosis: S83.252A, M94.262
Secondary Diagnosis: Z53.33
CPT: 27403-LT, 29877-LT - Answer MEDICAL RECORD
OPERATIVE NOTEAGE: 66 Sex: FEMALEDOS 1/1/20XXPHYSICIAN: Dr.PREOPERATIVE DIAGNOSIS:
Left knee meniscal tear.POSTOPERATIVE DIAGNOSIS: Left knee Lateral Bucket Handle Meniscal
