CPT® Code 27185

1. Indications

The procedure of epiphyseal arrest by epiphysiodesis or stapling at the greater trochanter of the femur is indicated for specific conditions related to abnormal growth patterns. The following are the primary indications for this surgical intervention:

• Overgrowth of the Greater Trochanter This condition can lead to functional impairments, including limited hip movement and altered gait mechanics.
• Hip Dysplasia In cases where hip dysplasia is present, epiphyseal arrest may be necessary to correct or prevent further complications associated with abnormal growth.
• Leg Length Discrepancy If there is a significant difference in leg lengths due to overgrowth, this procedure may be performed to help equalize the lengths and improve overall function.

2. Procedure

The surgical procedure for epiphyseal arrest by epiphysiodesis or stapling involves several critical steps to ensure effective treatment. The following outlines the procedural steps:

• Step 1: Incision The procedure begins with the surgeon making an incision over the lateral aspect of the hip. This incision allows access to the underlying structures, including the greater trochanter.
• Step 2: Dissection Following the incision, the soft tissues surrounding the greater trochanter are carefully dissected. This step is crucial for exposing the greater trochanter adequately while minimizing damage to surrounding tissues.
• Step 3: Epiphyseal Arrest Once the greater trochanter is exposed, the surgeon performs epiphyseal arrest. This is achieved through epiphysiodesis, which involves drilling across the physis of the greater trochanter. After drilling, screws are placed into the drilled holes, or staples are applied around the epiphyseal plate to halt further growth.
• Step 4: Closure After the epiphyseal arrest is completed, the incision is closed in layers. This layered closure technique is essential for promoting optimal healing and reducing the risk of complications.

3. Post-Procedure

Post-procedure care following epiphyseal arrest by epiphysiodesis or stapling is critical for recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort. Rehabilitation may be recommended to restore hip function and strength gradually. Patients are advised to follow up with their healthcare provider to assess the success of the procedure and to monitor for any potential issues related to growth or mobility.