CPT® Code 27187

Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur

Prophylactic treatment of the femoral neck or proximal femur is a surgical procedure aimed at enhancing the structural integrity of the bone, particularly in patients who are at risk due to conditions such as osteoporosis or osteolytic diseases, which may arise from bone metastases. This treatment is essential for preventing fractures and providing stability to weakened bones. The procedure can involve various techniques, including nailing, pinning, plating, or wiring, and may utilize methylmethacrylate, a type of bone cement, to further reinforce the bone. The approach can be minimally invasive, employing percutaneous techniques where small incisions are made to insert pins or screws under radiographic guidance. This method allows for precise placement of the fixation devices, which can include hollow cannulated screws that facilitate the injection of bone cement directly into the femoral neck. In cases where more extensive support is needed, a larger incision may be made to expose the proximal femur, allowing for the application of internal fixation devices such as plates and screws or wire cerclage. The procedure concludes with a layered closure of the surgical site to promote healing and minimize complications.