Medical Transcription Podiatry Operative Samples - For Medical Transcriptionists:
1. Arthrodesis of the naviculocuneiform joint, left foot.
2. Primary repair of the tibialis posterior tendon, left foot.
3. Excision of ganglionic cyst, left foot.
DESCRIPTION OF OPERATION: The patient was identified, taken to the operating room and placed on the operating room table in supine position. A well-padded thigh tourniquet was then placed above the patient's left thigh. Following IV sedation, local anesthesia was obtained about the left foot utilizing 20 mL of a 50:50 mixture of 0.5% Marcaine plain and 1% Xylocaine plain. The left lower extremity was then scrubbed, prepped and draped in the usual sterile fashion. The left lower extremity was elevated for approximately 5 minutes. An Esmarch bandage was applied to exsanguinate the left foot and ankle and lower leg and then the thigh tourniquet was inflated to 300 mmHg. Attention was then directed to the medial aspect of the left foot. An incision beginning from the distal aspect of the medial malleolus to the mid shaft level of the first metatarsal bone, following dorsomedially along the contours of the arch of the left foot, was performed. The incision was deepened into the subcutaneous layer. Care was taken to identify and retract all vital neurovascular structures. All bleeders were cauterized and ligated as necessary. Careful anatomical dissection revealed the deep fascial layer where at this time a surgical plane was created by incising through the deep fascial layer allowing good exposure to the tendons, joints and ligaments of the arch of the left foot. Further anatomical dissection revealed the joint capsule of the naviculocuneiform joint where at this time significant arthrosis was noted with immediate evidence of synovitis. The hypertrophic osteophyte was noted along the medial aspect of the joint. This was carefully excised. The remaining joint capsule was then incised and retracted. The joint was noted to be demonstrating significant cartilaginous denudation, with significant DJD of the naviculocuneiform joint. Next, utilizing a bone bur, the cartilage was resected to good bleeding bone of the naviculocuneiform joint. The wound was then copiously irrigated with normal sterile saline. No further cartilage or bone debris was noted. The cut bone ends were brought end-to-end and fixated with two Zimmer bone staples. The alignment of the naviculocuneiform joint was noted to be in rectus position relative to the arch of the left foot. Attention was then directed to the tibialis posterior tendon where at this time there appeared to be several linearly oriented in-continuity tears along with fatty degeneration and evidence of tenosynovitis. The tendon was also noted to be significantly hypertrophic relative to the surrounding tendon to the area, consistent with hypertrophic tear of the tibialis posterior tendon. Next, utilizing sharp debridement, the degenerative fatty tissue was sharply excised from the tibialis posterior tendon as well as the areas of fibrosis along the area of in-continuity tears. Then, utilizing 2-0 Ethibond suture, the tibialis posterior tendon was then primarily repaired, and to reinforce the primary repair, the remaining aspects of the tibialis posterior tendon were then anchored utilizing a 2.4 mm Mitek standard size bone anchor into the tuberosity of the navicular bone. The area was then copiously irrigated with normal sterile saline. No further debris was noted. Next, the joint capsule of the naviculocuneiform joint was then reapproximated and coapted utilizing 3-0 Vicryl. The deep fascial layer in addition to the first intracompartmental area of the retinaculum was then reapproximated and coapted utilizing 3-0 Vicryl as well. The subcutaneous area was then reapproximated and coapted utilizing 4-0 Vicryl and then incorporated into our final level of closure was a 10 French Blake catheter with 100 mL closed suction drain bulb syringe and then the skin and subcuticular were then reapproximated and closed utilizing 5-0 Vicryl suture. Attention was then directed to the dorsolateral aspect of the left midfoot where at this time a lazy S-type incision was made overlying the protruding ganglionic cyst area. The incision was deepened through the subcutaneous area. Care was taken to identify and retract all vital neurovascular structures. All bleeders were cauterized and ligated as necessary. Careful anatomical dissection through the subcutaneous layer revealed a protruding underlying ganglion cyst, underlying the extensor digitorum brevis muscle. The extensor digitorum brevis muscle was then carefully resected from its soft tissue attachments and then resected in the lateral direction exposing the ganglion cyst. The ganglion cyst was then carefully resected, passing off the operative field and sent to pathology as pathological specimen. The remaining area was then thoroughly explored and no further ganglion cysts were noted. The extensor digitorum brevis muscle was then placed back into its anatomical position and then the overlying superficial fascia was then reapproximated and closed utilizing 3-0 Vicryl and then the skin and subcutaneous layer reapproximated and closed utilizing 5-0 Vicryl suture. Upon completion of the procedure, 1 mL of 4 mg Decadron phosphate was injected above the incision site, as well as 10 mL of 0.5% Marcaine plain. The incisions were then dressed with triple antibiotic ointment, sterile Adaptic, 4 x 4 gauze sponges, super fluffs, and Kerlix. The thigh tourniquet was then deflated and an immediate hyperemic response was noted to all digits of the left foot consistent with intact vascular status to the left foot. Then, a Jones compression cast was applied consisting of cast padding and Ace wraps. The patient tolerated the procedure and anesthesia without any complications and was escorted from the operating room to the postanesthesia care unit with vital signs stable and vascular status intact to all digits of the left foot.
MT Sites Search Engine ---- Searches only MT Websites To Get You the Words You are Looking For:
For more Podiatry Operative Sample Reports, visit the original page at,