This "Present On Admission" (POA) indicator is recorded on CMS form 4010A. Orthopaedic Knowledge Update: Shoulder and Elbow, No.POA Exempt Code The Center for Medicare & Medicaid Services (CMS) requires medical coders to indicate whether or not a condition was present at the time of admission, in order to properly assign MS-DRG codes.AAOS/ASES Advanced Reconstruction Elbow, 2007.Operative Elbow Surgery: Expert Consult: 2012.Rockwood and Green's Fractures in Adults: 2009.Zohlman GL, in Masters Technique in Orthopedics - Fractures, 2005.24% reoperation usually for HWR (McKee JBJS 2000 82A:1701).ĭistal Humerus Fracture Review References Outcome after ORIF of intra-articular Fracture’s= Mean flexion contracture-25 degress, mean arc of motion-108 degrees, of normal strength.6 Months: return to full activities / sport.Consider bone stimulator if union is delayed. 3 Months: Ensure full restoration of shoulder and elbow ROM.6 Weeks: Begin active extension, strengthening exercises provided fracture union is evident on xray.Generally start physical therapy for ROM and strengthening 7-10 Days: Remove splint, begin passive shoulder and elbow ROM.2009 Jan-Feb 18(1):3-12.) Recommend permanent 5 pound lifting restriction to avoid loosening.ĭistal Humerus Fracture Associated Injuries / Differential Diagnosis Non-displaced: rare, consider non-op management if CT scan confirms 70y/o) / low funtional demand / inflammatory arthritis: Total Elbow Arthropasty (Cobb TK, JBJS 79A:826 1997), (Frankle MA, JOT 2003 17:473), (Kamineni S, JBJS 2004 86A:940) (McKee MD, JSES 2009 18:3) (McKee MD, J Shoulder Elbow Surg.3D reconstructions with radius and ulna subtracted are beneficial.ĭistal Humerus Fracture Classification / Treatment CT scan: typically indicated do to complexity of most distal humerus fractures. ![]()
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