M89.152 Complete physeal arrest, left proximal femur

Name of the Condition

• Complete physeal arrest, left proximal femur

Summary

Complete physeal arrest of the left proximal femur refers to the permanent cessation of growth at the growth plate (physis) of the left proximal femur, which can disrupt normal skeletal development. This condition may lead to limb length discrepancies or angular deformities, depending on the timing of arrest and the affected bone.

Causes

Complete physeal arrest of the left proximal femur can result from trauma, infection, radiation therapy, or certain medical conditions that damage the growth plate. It may also occur as a complication of orthopedic procedures or due to genetic disorders affecting bone growth.

Risk Factors

• Trauma to the growth plate, such as fractures or dislocations
• Infections (e.g., osteomyelitis) involving the growth plate
• Radiation therapy near the growth plate
• Underlying conditions like rickets or skeletal dysplasias
• Prior orthopedic surgeries involving the growth plate

Symptoms

• Limb length inequality (shorter left leg)
• Angular deformities (e.g., bowing or angulation of the left femur)
• Asymmetrical growth between limbs
• Pain or swelling at the affected growth plate
• Functional limitations due to deformity

Diagnosis

Diagnosis involves a physical examination to assess limb alignment and growth. Imaging studies, such as X-rays or MRI, are used to evaluate the growth plate and detect signs of arrest. Comparison of limb lengths and serial imaging may be necessary to confirm the diagnosis.

Treatment Options

Treatment depends on the severity of the deformity and may include observation, limb lengthening procedures, or corrective osteotomies. Orthotics or physical therapy may be used to manage symptoms or improve function.

Prognosis and Follow-Up

Prognosis varies based on the extent of growth disruption and the age at which arrest occurs. Regular follow-up with an orthopedic specialist is recommended to monitor growth and address any functional or cosmetic concerns.

Complications

Potential complications include persistent limb length discrepancy, angular deformity, joint instability, or early-onset arthritis in the affected hip or knee.

Lifestyle & Prevention

Preventive measures include prompt treatment of injuries or infections involving the growth plate. Avoiding unnecessary radiation exposure to the growth plate in children may reduce risk.

When to Seek Professional Help

Seek medical attention if there is noticeable limb asymmetry, pain, or functional limitations in the left leg, especially after trauma or infection.

Tips for Medical Coders

Document the specific location (left proximal femur) and the completeness of the physeal arrest. Include details about the cause (e.g., trauma, infection) and any associated deformities or functional limitations to support accurate coding.