CPT® Code 25430

The procedure described by CPT® Code 25430 involves the insertion of a vascular pedicle into a carpal bone, commonly referred to as the Hori procedure. This surgical intervention is specifically designed to restore blood supply to a carpal bone that has experienced ischemia, which can lead to osteonecrosis if not addressed. The carpal bones, particularly the lunate, are susceptible to a loss of blood supply for various reasons, resulting in potential complications such as pain, dysfunction, and structural failure of the bone. During the procedure, a surgical incision is made on the posterior aspect of the wrist, directly over the affected carpal bone. The surrounding tendons are carefully retracted to provide access to the underlying structures. The surgeon then isolates the terminal branches of the interosseous artery and vein, ligating and transecting them distal to the carpal bone to facilitate the mobilization of the vascular pedicle. A drill hole is created in the carpal bone to allow for the insertion of the interosseous artery and vein, which are then secured within the bone and attached to the periosteum to ensure proper blood flow. Finally, the joint capsule is repaired, and the soft tissues and skin are closed in layers, completing the procedure and aiming to restore normal function and blood supply to the affected carpal bone.