CPT® Code 25525

Open treatment of radial shaft fracture, includes internal fixation, when performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi fracture/ dislocation), includes percutaneous skeletal fixation, when performed

The CPT® Code 25525 refers to the open treatment of a radial shaft fracture, which includes internal fixation when necessary, as well as the closed treatment of a distal radioulnar joint (DRUJ) dislocation, commonly known as a Galeazzi fracture/dislocation. This procedure is characterized by a fracture located at the junction of the middle and distal thirds of the radial shaft, accompanied by a dislocation or subluxation of the DRUJ. The open reduction technique involves making an incision over the fracture site to access the radial shaft directly. The fractured bone pieces are then realigned using specialized tools such as fracture reduction forceps and manual traction, ensuring that the anatomical alignment of the radial shaft is restored. Verification of this alignment is typically performed through X-ray imaging. In cases where internal fixation is required, a compression plate and screws are utilized to stabilize the fracture. The procedure also addresses the DRUJ dislocation, which is assessed for its stability post-reduction of the radial shaft fracture. If the dislocation does not spontaneously reduce, a closed reduction technique is employed. Should the reduction prove unstable, percutaneous skeletal fixation may be necessary, involving the placement of K-wires from the ulna into the radius just proximal to the articular surface. After the procedure, the surgical wound is closed, and a long arm splint is applied to support the arm during the healing process. It is important to note that if the DRUJ dislocation cannot be reduced through closed means, an alternative procedure under CPT® Code 25526 must be considered, which involves open reduction of the DRUJ through a dorsal incision, along with potential stabilization using internal fixation devices.