CPT® Code 25920

An amputation through the wrist joint, referred to as disarticulation through the wrist, is a surgical procedure that involves the complete removal of the hand and wrist at the wrist joint. This procedure is performed when it is necessary to remove the hand due to severe injury, disease, or other medical conditions that compromise the viability of the hand. During the procedure, both palmar and dorsal flaps are created, which are sections of skin and soft tissue that are preserved to cover the area after the amputation. The surgical team carefully divides the finger flexor and extensor tendons, allowing them to retract, and identifies the wrist flexor and extensor tendons, which are then released from their distal insertions. The median and ulnar nerves, which are critical for hand function, are identified and sectioned above the amputation site to prevent nerve damage. Additionally, the radial and ulnar arteries are ligated to control bleeding. The actual disarticulation occurs just below the radius and ulna, with attention given to preserving the triangular fibrocartilage, an important structure for wrist stability. After the hand and wrist are severed, the remaining bone ends are rounded off, and the skin and soft tissue flaps are meticulously configured to cover the exposed areas, ensuring a proper healing environment. This procedure is essential for patients who require amputation to improve their quality of life, particularly when a prosthesis is to be fitted post-operatively.