CPT® Code 24410

1. Indications

The procedure described by CPT® Code 24410 is indicated for the treatment of specific conditions affecting the humeral shaft. These include:

• Rotational Deformity - This condition may arise from malunion, where the bone heals in an incorrect position, leading to functional impairment.
• Osteogenesis Imperfecta - A genetic disorder characterized by brittle bones, which may necessitate surgical intervention to correct deformities and improve bone stability.

2. Procedure

The procedure involves several critical steps to ensure successful correction of the deformity:

• Step 1: Incision and Exposure - An incision is made in the upper arm over the site of the deformity. The surgeon carefully dissects the soft tissues to expose the humerus, ensuring that the area is adequately visualized for the subsequent steps.
• Step 2: Elevation of the Periosteum - The periosteum, which is the fibrous membrane covering the bone, is elevated to allow access to the bone surface for the osteotomy.
• Step 3: Osteotomy Creation - Using surgical instruments such as a drill, saw, or osteotome, the bone is cut in a specific configuration determined by the type and location of the deformity. This may involve various osteotomy techniques, including transverse, wedge, or angular cuts.
• Step 4: Internal Fixation - After the osteotomies are performed, the bone fragments are aligned anatomically. Internal fixation devices, such as pins, screws, or plates, are applied as needed to secure the cut edges in their new position.
• Step 5: Insertion of Intramedullary Rod - An appropriately sized intramedullary rod is selected based on the dimensions of the humerus. A drill hole is created in either the distal or proximal aspect of the humerus, and the intramedullary canal is drilled or reamed through this hole. If a cannulated rod is used, a guidewire is placed into the canal to facilitate the rod's placement.
• Step 6: Positioning the Rod - The intramedullary rod is advanced over the guidewire until it is properly positioned within the canal. The bone is then anatomically positioned at each osteotomy site, and the rod is secured using screws, pins, or other fixation devices to maintain alignment during the healing process.

3. Post-Procedure

Post-procedure care following the multiple osteotomies with intramedullary rod insertion typically involves monitoring for complications, managing pain, and ensuring proper healing of the surgical site. Patients may require physical therapy to regain strength and mobility in the arm. Follow-up appointments are essential to assess the alignment of the bone and the stability of the fixation devices. The expected recovery time can vary based on the individual patient's condition and adherence to rehabilitation protocols.