Premier Surgery Center of Santa Maria
816 East Enos Drive, Suite B ♦ Santa Maria, CA 93454 ♦ (805) 347-7813
OPERATIVE REPORT
PATIENT NAME:
MEDICAL RECORD NUMBER:
PATIENT DATE OF BIRTH:
DATE OF SURGERY:
CHANEY, HILDA JEAN
0002054
04/08/1935
February 03, 2010
SURGEON:
ASSISTANT:
ANESTHESIOLOGIST:
ANESTHESIA:
DAVID STERLING, D.P.M.
NONE
KEITH SANTOYO, M.D.
LOCAL WITH MONITORED ANESTHESIA
CARE
PREOPERATIVE DIAGNOSIS:
1. Hallux extensus, Right Foot.
2. Exostosis, Right Hallux, distal phalanx.
POSTOPERATIVE DIAGNOSIS:
1. Hallux extensus, Right Foot.
2. Exostosis, Right Hallux, distal phalanx.
OPERATIVE PROCEDURE:
1. Arthrodesis, Right Hallux.
2. Excision of exostosis, Right Hallux, distal phalanx.
ANESTHESIA USED: Local anesthesia, with monitored anesthesia care, consisting of
approximately 3 cc of a 50/50 mixture of 0.5% Marcaine plain plus 1% Xylocaine plain. Added
to this was 0.5 cc of Decadron.
HEMOSTASIS: Pneumatic ankle tourniquet, Right lower extremity, inflated to 250mmHg.
ESTIMATED BLOOD LOSS: Less than 5.0 cc.
COMPLICATIONS: None.
FINDINGS AND PROCEDURE: The patient was brought into the operating room and placed
on the operating room table in the supine position. 1-gram Kefzol was administered IV
prophylactically.
Page 1 of 3
Premier Surgery Center of Santa Maria
816 East Enos Drive, Suite B ♦ Santa Maria, CA 93454 ♦ (805) 347-7813
OPERATIVE REPORT
PATIENT NAME:
MEDICAL RECORD NUMBER:
PATIENT DATE OF BIRTH:
DATE OF SURGERY:
CHANEY, HILDA JEAN
0002054
04/08/1935
February 03, 2010
An ankle tourniquet was applied. Via the use of monitored anesthesia, a local anesthetic was
administered to the surgical site as noted above. Once adequate anesthesia was achieved, the
foot was then prepped and draped in the usual sterile manner. An Esmarch bandage was applied
from toes to tourniquet on the right side, and the pneumatic tourniquet was inflated to 250mmHg
for hemostasis. The surgery then began.
Attention was first directed to the dorsal aspect overlying the interphalangeal joint of the right
hallux where an S-type incision was made. The incision started laterally proximally, and
traversed distally across the interphalangeal joint medially, and then distally towards the bony
exostosis on the distal phalanx. This incision was deepened taking care to note and avoid all
vital structures. All bleeders were cauterized. The incision was carried down to the tendo
capsular structure where this was then incised. The collateral ligament was severed. This
exposed the head of the proximal phalanx and base of the distal phalanx. Via the use of power
equipment, these were resected from dorsal plantar. At this time, via the use of various size
screws, it was noted that a 50 mm 4.0 cancellous screw of Vilex design best fit this area. There
was an incision made distally in the toe. The screw was implanted here, and traversed the distal
phalanx into the proximal phalanx for arthrodesing. There was noted to be excellent fixation at
this time. Excellent coaptation of the fusion site, and the hallux was in the rectus position. The
area here was then irrigated with copious amounts of sterile saline solution. The tendo capsular
structure was reapproximated closed via the use of 4-0 Vicryl. The subcutaneous tissues were
closed with 4-0 Vicryl. The skin edges were closed with 5-0 nylon.
Attention was then directed to the medial aspect of the distal phalanx where an incision was
made here. This incision was deepened down to the suspected exostosis, which was readily
identified. Via the use of power equipment this exostosis was resected from dorsal plantar. The
area here was then smoothed. The area was irrigated with copious amounts of sterile saline
solution. The skin edges were then coaptated closed via the use of 5-0 nylon suture. The areas
were then dressed with Adaptic, Betadine-soaked gauze, gauze and Kling with mild
compression. The tourniquet was then released and circulation to all digits was noted to be
within normal limits.
Page 2 of 3
Premier Surgery Center of Santa Maria
816 East Enos Drive, Suite B ♦ Santa Maria, CA 93454 ♦ (805) 347-7813
OPERATIVE REPORT
PATIENT NAME:
MEDICAL RECORD NUMBER:
PATIENT DATE OF BIRTH:
DATE OF SURGERY:
CHANEY, HILDA JEAN
0002054
04/08/1935
February 03, 2010
The patient was then transferred from the operatory room to the recovery room in apparent
satisfactory postoperative condition. There were no complications. Blood loss was estimated to
be less than 5.0 cc. It was felt that the patient left the operatory room in a much improved
condition.
_________________________
David Sterling, D.P.M.
DS/mes
D: 02/03/10
T: 02/04/10
Tracking #: CC96543
cc:
David Sterling, D.P.M.
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