The Use of Bone Age in Clinical Practice – Part 2
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Viewed at a Minimum Follow-Up of 2 Years (Maximum of 3 Years and 9 Months)
J Orthopaed Traumatol (2012) 13 (Suppl 1):S57–S89 DOI 10.1007/s10195-012-0210-2 12 NOVEMBER 2012 In-Depth Oral Presentations and Oral Communications IN-DEPTH ORAL PRESENTATIONS achieve a stable synthesis and an early mobilization of the MP and IP joints. However, if a malunion is present, it has to be corrected sur- gically as soon as possible. AT05–HAND AND WRIST Radio-distal epiphysis fractures: treatment with angular stability Treatment of malunion of the proximal phalangeal fractures plate of latest generation of the hand R. Di Virgilio*, E. Coppari, E. Condarelli, M. Rendine V. Potenza*, S. Bisicchia, R. Caterini, A. Fichera, P. Farsetti, E. Ippolito (Rome, IT) Universita` di Roma Tor Vergata (Rome, IT) Introduction Distal radius fractures are the most common fractures of the upper limb and coincide with 17 % of all fractures treated in Introduction It is difficult to treat fractures of the phalanges of the emergency rooms. The incidence of these fractures is greater in hand because they can cause complications such as deformity and patients aged 6 to 10 years, and in those between 60 and 70 years. joint limitation with a reduction in the grasping function. The most In older patients the incidence is higher in females. In the articular frequent complications are malunion of the fracture and joint limi- fractures, displaced, dislocated and highly unstable is indicated tation. The greatest incidence of complications can be found in open internal fixation (ORIF) to restore the congruity of the joint transverse fractures of the base of the proximal phalanx, in articular surface, to restore the correct length of the radius, its inclination fractures, comminuted fractures, and in those associated with lesions and palmar tilt. -
Knee Surgery-Arthroscopic and Open Procedures Version 1.0 Effective February 14, 2020
CLINICAL GUIDELINES CMM-312: Knee Surgery-Arthroscopic and Open Procedures Version 1.0 Effective February 14, 2020 Clinical guidelines for medical necessity review of Comprehensive Musculoskeletal Management Services. © 2019 eviCore healthcare. All rights reserved. Comprehensive Musculoskeletal Management Guidelines V1.0 CMM-312: Knee Surgery-Arthroscopic and Open Procedures CMM-312.1: Definitions 3 CMM-312.2: General Guidelines 5 CMM-312.3: Indications and Non-Indications 5 CMM-312.4: Experimental, Investigational, or Unproven 15 CMM-312.5: Procedure (CPT®) Codes 16 CMM-312.6: Procedure (HCPCS) Codes 19 CMM-312.7: References 20 ______________________________________________________________________________________________________ ©2020 eviCore healthcare. All Rights Reserved. Page 2 of 25 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Comprehensive Musculoskeletal Management Guidelines V1.0 CMM -312.1: Definitions The Modified Outerbridge Classification is a system that has been developed for judging articular cartilage injury to the knee. This system allows delineation of varying areas of chondral pathology, based on the qualitative appearance of the cartilage surface, and can assist in identifying those injuries that are suitable for repair techniques. The characterization of cartilage in this system is as follows: Grade I – Softening with swelling Grade II – Fragmentation and fissuring less than one square centimeter (1 cm2) Grade III – Fragmentation and fissuring greater than one square centimeter -
Pediatric Ankle Fractures
CHAPTER 26 PEDIATRIC ANKLE FRACTURES Sofi e Pinney, DPM, MS INTRODUCTION stronger than both the physis and bone. As a result, there is a greater capacity for plastic deformation and less chance of The purpose of this review is to examine the current intra-articular fractures, joint dislocation, and ligamentous literature on pediatric ankle fractures. I will discuss the disruptions. However, ligamentous injury may be more anatomic considerations of a pediatric patient, how to common than originally believed (1). A case-control study evaluate and manage these fractures, and when to surgically by Zonfrillo et al found an association between an increased repair them. Surgical techniques and complications will be risk of athletic injury in obese children, and concluded a briefl y reviewed. higher body mass index risk factor for ankle sprains (4). Ankle fractures are the third most common fractures in Secondary ossifi cation centers are located in the children, after the fi nger and distal radial physeal fracture. epiphysis. The distal tibial ossifi cation center appears at 6-24 Approximately 20-30% of all pediatric fractures are ankle months of age and closes asymmetrically over an 18-month fractures. Most ankle fractures occur at 8-15 years old. The period fi rst central, then medial and posterior, with the peak injury age is 11-12 years, and is relatively uncommon anterolateral portion closing last at 15 and 17 years of age for under the age 5. This injury is more common in boys. females and males, respectively. The distal fi bula ossifi cation The most common cause of pediatric ankle fractures is a center appears at 9-24 months of age and closes 1-2 years rotational force, and is often seen in sports injuries associated after the distal tibial. -
Commercial Musculoskeletal Codes
Updated January 2018 Commercial Musculoskeletal Codes Investigational or Non-Covered Spine Surgery Pain Management Joint Surgery Codes associated with an Arthrogram CPT Description Commercial Notes Partial excision of posterior vertebral component (eg, spinous 22100 process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervical 22101 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracic 22102 Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbar Partial excision of posterior vertebral component (eg, spinous process, 22103 lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure) Partial excision of vertebral body, for intrinsic bony lesion, without 22110 decompression of spinal cord or nerve root(s), single vertebral segment;cervical Partial excision of vertebral body, for intrinsic bony lesion, without 22112 decompression of spinal cord or nerve root(s), single vertebral segment; thoracic Partial excision of vertebral body, for intrinsic bony lesion, without 22114 decompression of spinal cord or nerve root(s), single vertebral segment; lumbar each additional vertebral segment (list separately in addition to code 22116 for primary procedure) Osteotomy of spine, posterior or posterolateral approach, 3 columns, 22206 1 vertebral -
Ankle Injuries
Pediatric Fractures of the Ankle Nicholas Frane DO Zucker/Hofstra School of Medicine Northwell Health Core Curriculum V5 Disclosure • Radiographic Images Courtesy of: Dr. Jon-Paul Dimauro M.D or Christopher D Souder, MD, unless otherwise specified Core Curriculum V5 Outline • Epidemiology • Anatomy • Classification • Assessment • Treatment • Outcomes Core Curriculum V5 Epidemiology • Distal tibial & fibular physeal injuries 25%-38% of all physeal fractures • Ankle is the 2nd most common site of physeal Injury in children • Most common mechanism of injury Sports • 58% of physeal ankle fractures occur during sports activities • M>F • Commonly seen in 8-15y/o Hynes D, O'Brien T. Growth disturbance lines after injury of the distal tibial physis. Their significance in prognosis. J Bone Joint Surg Br. 1988;70:231–233 Zaricznyj B, Shattuck LJ, Mast TA, et al. Sports-related injuries in school-aged children. Am J Sports Med. 1980;8:318–324. Core Curriculum V5 Epidemiology Parikh SN, Mehlman CT. The Community Orthopaedic Surgeon Taking Trauma Call: Pediatric Ankle Fracture Pearls and Pitfalls. J Orthop Trauma. 2017;31 Suppl 6:S27-S31. doi:10.1097/BOT.0000000000001014 Spiegel P, et al. Epiphyseal fractures of the distal ends of the tibia and fibula. J Bone Joint Surg Am. 1978;60(8):1046-50. Core Curriculum V5 Anatomy • Ligamentous structures attach distal to the physis • Growth plate injury more likely than ligament failure secondary to tensile weakness in physis • Syndesmosis • Anterior Tibio-fibular ligament (AITFL) • Posterior Inferior Tibio-fibular -
CMM-314: Hip Surgery-Arthroscopic and Open Procedures Version 1.0.2019
CLINICAL GUIDELINES CMM-314: Hip Surgery-Arthroscopic and Open Procedures Version 1.0.2019 Clinical guidelines for medical necessity review of speech therapy services. © 2019 eviCore healthcare. All rights reserved. Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-314: Hip Surgery-Arthroscopic and Open Procedures CMM-314.1: Definitions 3 CMM-314.2: General Guidelines 4 CMM-314.3: Indications and Non-Indications 4 CMM-314.4 Experimental, Investigational, or Unproven 6 CMM-314.5: Procedure (CPT®) Codes 7 CMM-314.6: References 10 © 2019 eviCore healthcare. All rights reserved. Page 2 of 13 400 Buckwalter Place Boulevard, Bluffton, SC 29910 • (800) 918-8924 www.eviCore.com Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-314.1: Definitions Femoroacetabular Impingement (FAI) is an anatomical mismatch between the head of the femur and the acetabulum resulting in compression of the labrum or articular cartilage during flexion. The mismatch can arise from subtle morphologic alterations in the anatomy or orientation of the ball-and-socket components (for example, a bony prominence at the head-neck junction or acetabular over-coverage) with articular cartilage damage initially occurring from abutment of the femoral neck against the acetabular rim, typically at the anterosui per or aspect of the acetabulum. Although hip joints can possess the morphologic features of FAI without symptoms, FAI may become pathologic with repetitive movement and/or increased force on the hip joint. High-demand activities may also result in pathologic impingement in hips with normal morphology. s It ha been proposed that impingement with damage to the labrum and/or acetabulum is a causative factor in the development of hip osteoarthritis, and that as many as half of cases currently categorized as primary osteoarthritis may have an etiology of FAI. -
Affecting Factors and Correction Ratio in Genu Valgum Or Varum Treated with Percutaneous Epiphysiodesis Using Transphyseal Screw
Journal of Clinical Medicine Article Affecting Factors and Correction Ratio in Genu Valgum or Varum Treated with Percutaneous Epiphysiodesis Using Transphyseal Screws Si-Wook Lee * , Kyung-Jae Lee , Chul-Hyun Cho, Hee-Uk Ye, Chang-Jin Yon , Hyeong-Uk Choi, Young-Hun Kim and Kwang-Soon Song Department of Orthopedic Surgery, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, 1035 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea; [email protected] (K.-J.L.); [email protected] (C.-H.C.); [email protected] (H.-U.Y.); [email protected] (C.-J.Y.); [email protected] (H.-U.C.); [email protected] (Y.-H.K.); [email protected] (K.-S.S.) * Correspondence: [email protected]; Tel.: +82-53-258-4771 Received: 30 November 2020; Accepted: 17 December 2020; Published: 18 December 2020 Abstract: This study evaluated the correction rates of idiopathic genu valgum or varum after percutaneous epiphysiodesis using transphyseal screws (PETS) and analyzed the affecting factors. A total of 35 children without underlying diseases were enrolled containing 64 physes (44 distal femoral (DT), 20 proximal tibial (PT)). Anatomic tibiofemoral angle (aTFA) and the mechanical axis deviation (MAD) were taken from teleroentgenograms before PETS surgery and screw removal. The correction rates of the valgus and varus deformities for patients treated with PETS were 1.146◦/month and 0.639◦/month using aTFA while using MAD showed rates of 4.884%/month and 3.094%/month. After aTFA (p < 0.001) and MAD (p < 0.001) analyses, the correction rate of DF was significantly faster than that of PT. -
Statistical Analysis Plan
~ GILEAU STATISTICAL ANALYSIS PLAN Study Title: A Phase 2, Randomized, Open Label Study to Evaluate the Efficacy and Safety ofTenofovir Alafenamide (fAF) versus Tenofovir Disoproxil Fumarate (fDF)-containing Regimens in Subjects with Chmnic HBV Infection and Stage 2 or Greater Chronic Kidney Disease Who Have Received a Liver Transplant Name of Test Drug: Tenofovir Alafenamide (fAF) Study Number: GS-US-320-3912 Protocol Version (Date): Amendment 2 (28 March 2017) Analysis Type: Week 24 Analysis Plan Version: Version 1.0 Analysis Plan Date: 19 March 2018 ..._ ...... Analysis Plan Author(s): PD______ CONFIDENTIAL AND PROPRIETARY INFORMATION TAF GS-US-320-3912 Statistical Analysis Plan – Week 24 Analysis Version 1.0 TABLE OF CONTENTS TABLE OF CONTENTS ..............................................................................................................................................2 LIST OF IN-TEXT TABLES........................................................................................................................................4 LIST OF ABBREVIATIONS........................................................................................................................................5 1. INTRODUCTION ................................................................................................................................................8 1.1. Study Objectives ......................................................................................................................................8 1.2. Study Design ............................................................................................................................................9 -
Ipo) List for Cy 2021 (N=266)
TABLE 31: PROPOSED MUSCULOSKELETAL-RELATED SERVICE REMOVALS FROM THE INPATIENT ONLY (IPO) LIST FOR CY 2021 (N=266) CY CY 2020 Long Descriptor Related Proposed Proposed 2020 Services CY 2021 CY 2021 CPT OPPS OPPS APC Code Status Assignment Indicator 0095T Removal of total disc arthroplasty 22856 N/A (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) 0098T Revision including replacement 22858 N/A of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) 0163T Total disc arthroplasty (artificial 22858 N/A disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to code for primary procedure) 0164T Removal of total disc 22856 N/A arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) 0165T Revision including replacement 22858 N/A of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) 0202T Posterior vertebral joint(s) 63030 J1 5115 arthroplasty (for example, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine -
Corrective Osteotomy After Damage of the Distal Radial Physis in Children: Surgical Technique and Results
TECHNIQUE Corrective Osteotomy After Damage of the Distal Radial Physis in Children: Surgical Technique and Results Ricardo Kaempf de Oliveira, MD,* Pedro J. Delgado Serrano, MD,w Alejandro Badia, MD,z and Marco Tonding Ferreira, MDy The treatment depends on the physeal compromise, the Abstract: Distal radial physis closure in children can develop severe child’s growth potential, and the deformity. Near-complete wrist deformity (radial shortening). These patients can be treated using physeal closure creates distal radius shortening and angulation a single-step surgery. It was carried out in the form of a corrective that can compromise joint function, and create pain and osteotomy adopting the volar approach, with fixed-angle volar plate instability. Surgical treatment with different techniques, either fixation and bone grafting from the iliac crest. There have been few alone or combined, such as 1 or 2-staged bone lengthening descriptions of the use of this technique in the management of osteotomy, external fixation, and ulnar shortening with or deformities related to early epiphysiodesis in distal radius. The use of without epiphysiodesis, is indicated to correct the deformity.2 fixation systems for the radius, using fixed-angle locking plates, allows radius lengthening adjusted to demand after osteotomy, using the combination of the plate and distal locking pins as spacer—with custom- INDICATIONS sized tricortical iliac crest grafting within the defect. The freeing of soft The authors propose a novel, not earlier described in the literature, parts such as the dorsal periosteum and brachioradialis muscle tendon surgical technique for the treatment of deformities caused by allows adequate bone lengthening in a single-surgical step. -
2019 Compilation of Inpatient Only Procedure Lists by Specialty
2019 Compilation of Inpatient Only Procedure Lists by Specialty (for CPT searching) 2019 Bariatric Surgery: Is the Surgery Medicare Inpatient Only or not? Disclaimer: This is not the CMS Inpatient Only Procedure List (Annual OPPS Addendum E). No guarantee can be made of the accuracy of this information which was compiled from public sources. CPT Codes are property of the AMA and are made available to the public only for non-commercial usage. Gastric Bypass or Partial Gastrectomy Procedures Inpatient Only Procedure Not an Inpatient Only Procedure 43644 Laparoscopy, surgical, gastric restrictive 43659 Unlisted laparoscopy procedure, stomach procedure; with gastric bypass and Roux-en-Y gastroenterostomy (roux limb 150 cm or less) 43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption 43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy) 43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical- banded gastroplasty 43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with duodenal switch) 43846 Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or less) Roux-en-Y gastroenterostomy 43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction -
Articular Cartilage Lesions : Advances in Conservative and Surgical Interventions
Articular cartilage lesions : advances in conservative and surgical interventions Citation for published version (APA): Jansen, E. J. P. (2008). Articular cartilage lesions : advances in conservative and surgical interventions. Maastricht University. https://doi.org/10.26481/dis.20081107ej Document status and date: Published: 01/01/2008 DOI: 10.26481/dis.20081107ej Document Version: Publisher's PDF, also known as Version of record Please check the document version of this publication: • A submitted manuscript is the version of the article upon submission and before peer-review. There can be important differences between the submitted version and the official published version of record. People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.