Freiberg病诊断及手术编码分析  

Analysis of diagnosis and surgical coding of Freiberg disease

作　　者：王海军[1] 部文茜[1] Wang Haijun;Bu Wenqian(The Second Hospital of Tangshan,Tangshan 063000,Heibei Province,China)

机构地区：[1]唐山市第二医院,河北省唐山市063000

出　　处：《中国病案》2025年第1期43-45,共3页Chinese Medical Record

摘　　要：Freiberg病是常见的原发性骨软骨病,又称第2跖骨头缺血性坏死或跖骨头骨软骨病。Freiberg病在ICD-10中以人名音译弗赖伯格作为主导词可以直接查找,分类在M92.7幼年型跖骨骨软骨病。Freiberg病的治疗以Smillie分期为指导,早期保守治疗无效可采用关节保留手术,关节清理术80.88、钻孔减压术77.18、背侧楔形截骨术77.2;晚期跖骨头坏死严重,跖趾关节不稳出现锤状趾或交叉趾畸形、跖趾关节病,可采用关节牺牲手术,锤状趾修补术77.56、叠交趾修补术77.58、骨软骨移植术77.58、Swanson人工跖趾关节置换术81.57。以Freiberg病诊断和手术临床分类为参考,结合ICD-10和ICD-9-CM-3分类规则和临床案例给出编码思路,为Freiberg病诊断及手术编码规范化选择提供参考,以提高Freiberg病诊断与手术编码的准确性。Freiberg's disease is a common primary osteochondrosis, also known as avascular necrosis of the second metatarsal head or osteochondrosis of the metatarsal head. Freiberg disease can be found directly in ICD-10with the transliteral name Freiberg as the dominant word, classified in M92.7 juvenile metatarsal osteochondritis.The treatment of Freiberg's disease is guided by Smillie stage. Joint preservation surgery, joint debridement 80.88,drilling decompression 77.18, and dorsal wedge osteotomy 77.2 can be used if early conservative treatment failed.In the late stage, when metatarsal head necrosis is severe, metatarsophalangeal joint instability occurs, hammer toe or crossed toe deformity, and metatarsophalangeal joint disease occurs, joint sacrificial surgery can be used,including hammer toe repair 77.56, overlapped toe repair 77.58, osteochondral transplantation 77.58, and Swanson artificial metatarsophalangeal joint replacement 81.57. Based on the diagnosis of Freiberg's disease and the clinical classification of surgery, this study provides coding ideas in combination with ICD-10 and ICD-9-CM-3classification rules and clinical cases, so as to provide references for the standardized selection of Freiberg's disease diagnosis and surgical coding, so as to improve the accuracy of Freiberg disease diagnosis and surgical coding.

关 键 词：FREIBERG病 疾病分类 手术分类 编码 

分 类 号：R68[医药卫生—骨科学]