S42.018 Nondisplaced fracture of sternal end of left clavicle

Name of the Condition

• Nondisplaced fracture of sternal end of left clavicle (ICD-10 Code: S42.018)

Summary

A nondisplaced fracture of the sternal end of the left clavicle is a break in the inner portion of the left collarbone, where it connects to the sternum (breastbone). The bone fragments remain aligned, meaning the fracture does not involve significant displacement. This type of injury typically affects the medial third of the clavicle and may range from minor cracks to complete breaks without misalignment.

Causes

This fracture usually results from direct trauma to the shoulder or chest, such as a fall onto the shoulder, a motor vehicle accident, or a forceful impact to the sternum. It can also occur during contact sports or activities involving sudden force to the upper body. The nondisplaced nature suggests the force was not severe enough to shift the bone fragments out of position.

Risk Factors

Factors that increase the risk include participation in high-impact sports, osteoporosis or reduced bone density, and older age due to increased fall risk. Anatomical variations in clavicle structure may also play a role. Activities with a high risk of falls or collisions, such as skiing or cycling, can elevate the likelihood of this injury.

Symptoms

Symptoms often include localized pain at the sternal end of the left clavicle, swelling, bruising, tenderness, and difficulty moving the shoulder. A visible deformity or bump may be present at the fracture site, though less pronounced than in displaced fractures. Pain may worsen with movement or pressure.

Diagnosis

Diagnosis involves a physical examination to assess pain and deformity, followed by X-ray imaging to confirm the fracture and its location. Additional imaging like CT or MRI may be used for complex cases or if other injuries are suspected. The nondisplaced nature is confirmed by imaging showing aligned bone fragments.

Treatment Options

Treatment typically includes immobilization with a sling or brace to limit shoulder movement and allow healing. Pain management with over-the-counter or prescription medications may be recommended. Physical therapy is often introduced later to restore strength and mobility. Most nondisplaced fractures heal without surgery, but follow-up imaging may be used to monitor progress.

Prognosis and Follow-Up

The prognosis for a nondisplaced fracture of the sternal end of the left clavicle is generally good, with most cases healing within 6–8 weeks. Follow-up appointments are important to assess healing and adjust treatment as needed. Complications are rare but may include delayed union or nonunion, which require further evaluation.

Complications

Complications are uncommon but may include infection, nerve or blood vessel damage near the fracture site, or malunion (healing in an abnormal position). Persistent pain or limited mobility after healing may indicate a need for additional treatment.

Lifestyle & Prevention

Preventive measures include wearing protective gear during contact sports, maintaining bone health through diet and exercise, and avoiding high-risk activities. Strengthening shoulder and upper body muscles can help reduce injury risk. For older adults, fall prevention strategies, such as home modifications, are beneficial.

When to Seek Professional Help

Seek medical attention if pain is severe, swelling worsens, or there is difficulty moving the arm. Signs of infection, such as redness, warmth, or fever, also require prompt evaluation. If symptoms do not improve with initial treatment or if new symptoms develop, consult a healthcare provider.

Tips for Medical Coders

Document the fracture as "nondisplaced" and specify the left clavicle to ensure accurate coding. Include details about the mechanism of injury, imaging results, and treatment plan to support the diagnosis. Ensure the code S42.018 is used only when the fracture is confirmed as nondisplaced and involves the sternal end of the left clavicle.