CPT® Code 25440

Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial styloidectomy (includes obtaining graft and necessary fixation)

The procedure described by CPT® Code 25440 pertains to the surgical repair of a nonunion of the scaphoid carpal bone, also known as the navicular bone. A nonunion occurs when the fracture fragments fail to heal properly after an adequate period, leading to persistent pain and dysfunction in the wrist. This condition is particularly significant in the scaphoid bone due to its critical role in wrist stability and movement. The procedure may also involve a radial styloidectomy, which is the surgical removal of the radial styloid process, a bony prominence at the distal end of the radius that can cause mechanical pain by impinging on the scaphoid bone. The surgical approach typically involves making an incision on the posterior aspect of the wrist to access the scaphoid bone directly. During the operation, the surgeon evaluates the nonunion site, removes any scar tissue, and prepares the bone for grafting. A local bone graft is harvested from the radius to facilitate the healing of the scaphoid. The procedure includes the use of internal fixation methods, such as pins or wires, to stabilize the bone fragments and the graft, ensuring proper alignment and support during the healing process. This comprehensive approach aims to restore function and alleviate pain associated with scaphoid nonunion.