S52.225H Nondisplaced transverse fracture of shaft of left ulna, subsequent encounter for open fracture type I or II with delayed healing

Name of the Condition

• Nondisplaced transverse fracture of shaft of left ulna, subsequent encounter for open fracture type I or II with delayed healing

Summary

A nondisplaced transverse fracture of the shaft of the left ulna is a straight-line break across the long, central portion of the ulna bone (one of the two forearm bones) where the bone fragments remain in their normal anatomical alignment. The fracture runs horizontally through the bone shaft, and the lack of displacement means the bone pieces are not shifted out of position. This is a subsequent encounter for an open fracture type I or II, indicating the skin was breached but the wound is typically small and clean, and healing is progressing more slowly than expected.

Causes

Direct trauma to the forearm, such as from a fall, blow, or accident. High-impact injuries, including sports-related incidents or motor vehicle collisions. Indirect forces transmitted through the wrist or elbow, potentially causing a break in the ulna shaft.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or other conditions that weaken bone density.
• Previous fractures or bone abnormalities that may predispose to injury.
• Advanced age, which can reduce bone strength.

Symptoms

• Pain and tenderness localized to the forearm.
• Swelling and bruising around the injured area.
• Difficulty moving the arm, wrist, or hand due to pain or instability.
• Possible visible deformity if the fracture is displaced (though less common in nondisplaced cases).

Diagnosis

Physical examination to assess tenderness, swelling, and range of motion. Imaging studies, such as X-rays, to confirm the fracture type, location, and healing status. Evaluation of the open wound (if present) to determine its size and cleanliness. Assessment of healing progress to identify delayed union.

Treatment Options

Immobilization with a cast or splint to stabilize the fracture and promote healing. Wound care for open fractures to prevent infection. Pain management with medications or other therapies. Monitoring of healing progress through follow-up imaging. Possible surgical intervention if healing does not improve with conservative measures.

Prognosis and Follow-Up

Healing may take longer than typical due to delayed union. Regular follow-up appointments to assess progress and adjust treatment as needed. Physical therapy to restore strength and mobility once healing allows. Long-term monitoring for potential complications, such as nonunion or infection.

Complications

Delayed healing or nonunion of the fracture. Infection, particularly with open fractures. Nerve or blood vessel damage in the forearm. Stiffness or reduced range of motion in the arm or wrist.

Lifestyle & Prevention

Avoid high-impact activities until fully healed. Use protective gear during sports or work to reduce injury risk. Maintain bone health through diet and exercise to support healing. Follow medical advice for weight-bearing and activity restrictions.

When to Seek Professional Help

Increased pain, swelling, or redness around the injury site. Signs of infection, such as fever or pus. Numbness, tingling, or weakness in the hand or fingers. Difficulty moving the arm or wrist despite treatment.

Tips for Medical Coders

Document the fracture type (nondisplaced transverse), location (shaft of left ulna), encounter type (subsequent), open fracture classification (type I or II), and delayed healing status. Ensure clinical notes support the open fracture and delayed healing to justify the code. Verify that the encounter is subsequent, not initial, and that healing is progressing slower than expected.