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Hedrick Surgical Dictation Templates

Metatarsal Head Resection

1. This patient was brought to the operating room and placed comfortably in the supine position. This was after an ankle block was performed by the anesthesia service in the preop holding area. The lower extremity was prepped and draped in a sterile fashion. It was then elevated, exsanguinated, and Esmarch tourniquet placed about the ankle.

2. Attention was then turned to the forefoot for metatarsal head resection and extensor tenotomies, A 4-cm longitudinal incision was made directly over the metatarsal using a 15 blade. Further dissection was performed using the tenotomy scissors. The extensor digitorum longus and brevis tendons to each digit were identified and transected using the tenotomy scissors. This completed the extensor tendon tenotomies.

3. Attention was then turned to the deeper metatarsal head for metatarsal head resection. It was transected obliquely using the oscillating saw. The metatarsal head was then removed using the 15 blade and a towel clip. The toe was then pinned in a retrograde and antegrade fashion down its length and into the metatarsal shaft. These pins were cut off and Jurgens balls placed on the ends of the pins for protection. The surgical site was then copiously irrigated with saline solution. The skin was then closed using 4-0 nylon interrupted horizontal mattress stitches.

4. A sterile dressing was then applied to the foot and the tourniquet was then removed. The patient then placed into a postop shoe, transferred to the recliner and taken to the stepdown area in stable condition. Estimated blood loss from this procedure was less than 5 mL. The patient tolerated the procedures well. There were no complications.