CPT® Code 24635

Open treatment of Monteggia type of fracture dislocation at elbow (fracture proximal end of ulna with dislocation of radial head), includes internal fixation, when performed

An open treatment of a Monteggia type fracture dislocation at the elbow involves a surgical procedure aimed at correcting a specific type of injury characterized by a fracture at the proximal end of the ulna accompanied by a dislocation of the radial head. This injury typically occurs due to trauma and requires precise surgical intervention to restore the normal anatomy of the elbow joint. The procedure begins with an incision made to access the fractured ulna, allowing the surgeon to visualize and address the fracture directly. The first step in the treatment is the reduction of the ulnar fracture, which involves aligning the fractured bone ends to promote proper healing. Once the fracture is adequately reduced, internal fixation may be applied to stabilize the fracture. This is often achieved using devices such as dynamic compression plates or limited contact-dynamic compression plates, which are secured with screws placed just above and below the fracture site. Following the successful reduction of the ulnar fracture, the dislocated radial head is typically expected to reduce indirectly. However, if it does not, an additional incision may be necessary to perform an open reduction of the radial head, which may also involve repairing the annular ligament to ensure joint stability. After both the ulnar fracture and radial head are properly aligned and stabilized, the surgical wounds are closed, and a splint is applied to support the elbow during the initial healing phase.