CPT® Code 25922

An amputation through the wrist joint, referred to as disarticulation, involves the surgical removal of the hand and wrist at the level of the wrist joint. This procedure is performed when there is a need to remove the hand due to various medical conditions, such as severe trauma, infection, or other pathological conditions that compromise the integrity of the hand and wrist. The surgical technique includes the creation of palmar and dorsal flaps, which are formed from the skin and soft tissue surrounding the wrist, allowing for effective closure of the surgical site. During the procedure, the finger flexor and extensor tendons are carefully divided and allowed to retract, while the wrist flexor and extensor tendons are identified, released, and reflected away from the operative area. The median and ulnar nerves, which are critical for hand function, are also identified and sectioned above the amputation site to prevent any nerve damage during the procedure. Additionally, the radial and ulnar arteries are ligated to control bleeding. The disarticulation is performed just below the radius and ulna, ensuring that the triangular fibrocartilage is preserved to maintain the integrity of the wrist joint. After the amputation, the skin and soft tissue flaps are meticulously configured to cover the distal ends of the radius and ulna. In cases where a secondary closure or scar revision is necessary, the procedure aims to create a pain-free stump that is well-suited for prosthetic use. This involves debriding the raw surface of the stump, excising any devitalized tissue, and fashioning skin flaps to cover the area, ensuring optimal healing and functionality.