Since the skeletal system includes bones and cartilage, it is possible to have a procedure on the skeletal system, i.e. on cartilage, that is not a procedure on bone.
For example,
- 77825002 |Division of cartilage of wrist (procedure)| is a procedure on the skeletal system (procedure)
Skeletal system subdivision
SNOMED CT considers the skeletal system subdivision part of the entire bone (system). This may change if there are procedures on cartilaginous skeleton that involve skeletal system subdivisions.
Osteotomy
Osteotomy is defined as cutting into or through a bone; there are 3 meanings in SNOMED CT:
- Cutting into a bone, regardless of whether the bone is divided (incision, general meaning). Model using Method, Incision - action (qualifier value), and Procedure site - Direct (attribute), bone structure (or subtypes).
For example,
- Cutting through a bone and dividing it (division by cutting). Model using Method, Division - action (qualifier value), and Procedure site - Direct (attribute), bone structure (or subtypes).
For example,
3. Cutting into a bone without cutting through it and therefore without dividing it (incision without division).
This is unnecessary; procedures that do not explicitly involve division are modeled simply as Incision.
Reduction and fixation of fractures
Reduction and fixation has two actions by two different means; open reduction of a fracture and insertion of an orthopedic fixation device. This provides an opportunity for general concept inclusion axioms (GCIs) in order to fully represent the meanings without heavy postcoordination modeling. Open reduction of a fracture necessarily involves open manipulation of the fracture and internal fixation of a fracture necessarily involves the insertion of an orthopedic internal fixation device.
For example,
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