CPT® Code 25405

The procedure described by CPT® Code 25405 involves the surgical repair of a nonunion or malunion of the radius or ulna, specifically when a bone graft is utilized. A nonunion occurs when the fracture fragments fail to heal together after an adequate period, while a malunion refers to the improper alignment of the fracture fragments, which can lead to various complications such as osseous abnormalities, incongruity of articular surfaces, soft tissue contracture, and nerve impingement. During the procedure, the surgeon exposes the original fracture sites of the radius and/or ulna to assess the condition of the nonunion or malunion. Depending on the evaluation, the repair may involve internal fixation techniques, which can be performed with or without the addition of a bone graft. In cases where internal fixation is applied without a graft, a compression plate may be used to stabilize the fracture. For nonunions, a compression plate is placed over the fracture site and secured with lag screws, while malunions may require refracturing and realigning the bone to restore anatomical alignment. If a bone graft is necessary, the site is prepared, which may involve refracturing the bone to facilitate healing. An autograft is typically harvested from the iliac crest, where a skin incision is made, and the muscle is stripped to expose the bone surface for harvesting cortical and/or cancellous bone. The harvested bone is then shaped to fit the defect, and internal fixation devices may be employed to secure the graft in place. This comprehensive approach aims to restore proper alignment and stability to the fractured bone, promoting effective healing and recovery.