CPT® Code 28636

The CPT® Code 28636 refers to the procedure known as percutaneous skeletal fixation of a metatarsophalangeal joint dislocation, which includes manipulation of the dislocated joint. This procedure is performed to address dislocations that occur at the metatarsophalangeal joint, which is the joint located at the base of the toes where the metatarsal bones meet the proximal phalanges. The term 'percutaneous' indicates that the procedure is performed through the skin with minimal incisions, allowing for less trauma to the surrounding tissues compared to open surgical techniques. During the procedure, a small incision is made over the affected metatarsal or phalangeal bone, and a drill is utilized to create a corticotomy, which is a surgical opening in the cortex of the bone. This allows for access to the dislocated bones, which are then carefully manipulated back into their proper anatomical position. To ensure that the joint remains stable and in alignment during the healing process, one or more pre-bent Kirschner wires are inserted through the medullary canals of the metatarsal and phalangeal bones. The successful reduction of the dislocation is confirmed through radiographic imaging, which is reported separately. This procedure is essential for restoring function and alleviating pain associated with metatarsophalangeal joint dislocations.