S52.365K Nondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with nonunion

Name of the Condition

Nondisplaced segmental fracture of shaft of radius, left arm, subsequent encounter for closed fracture with nonunion
ICD-10 Code: S52.365K

Summary

A nondisplaced segmental fracture of the shaft of the radius is a break in the long, outer bone of the forearm (radius) between the elbow and wrist, where the bone is separated into two or more fragments that remain in their original alignment. This injury typically results from significant trauma and may impair arm function depending on associated soft tissue damage. The "nondisplaced" nature means the bone fragments are not shifted out of position, which can influence treatment and recovery. The "subsequent encounter for closed fracture with nonunion" specifies this is a follow-up visit for a fracture where the skin is intact but the bone has failed to heal properly.

Causes

This fracture commonly occurs due to direct trauma, such as falls onto an outstretched arm, high-impact blows to the forearm, or accidents involving twisting forces at the wrist or elbow. Motor vehicle collisions, sports injuries, or forceful impacts may also cause the bone to break into multiple segments without displacing them. Nonunion may develop if the initial fracture does not heal within the expected timeframe, often due to inadequate immobilization, poor blood supply, or infection.

Risk Factors

• Participation in contact sports or activities with a high risk of falls
• Osteoporosis or weakened bone density
• Advanced age, which increases fracture susceptibility
• Previous forearm or wrist injuries
• Occupations or hobbies involving repetitive stress or heavy lifting
• Smoking or poor nutrition, which can impair bone healing

Symptoms

• Persistent pain at the injury site, often worsening with activity
• Swelling, bruising, or deformity of the forearm
• Inability to move the wrist or elbow fully
• A visible gap or abnormal motion at the fracture site (if nonunion is severe)
• Numbness or tingling in the hand or fingers (if nerve involvement occurs)

Diagnosis

Diagnosis typically involves a physical examination to assess pain, swelling, and range of motion, followed by imaging studies. X-rays are the primary tool to confirm the fracture and evaluate healing progress. If nonunion is suspected, additional imaging such as CT scans or MRI may be used to assess bone union and rule out other complications. The "subsequent encounter" designation indicates the patient is being seen for follow-up after initial treatment.

Treatment Options

Treatment focuses on promoting bone healing and restoring function. Options may include immobilization with a cast or brace to stabilize the fracture, physical therapy to maintain mobility and strength, and in some cases, surgical intervention such as bone grafting or internal fixation to stimulate union. Pain management and monitoring for complications are also key components of care.

Prognosis and Follow-Up

Prognosis depends on the severity of the nonunion and the effectiveness of treatment. With appropriate management, many patients achieve successful healing, though recovery may take longer than for acute fractures. Regular follow-up appointments are necessary to monitor healing progress and adjust treatment as needed. Long-term outcomes often include restored function, but some residual stiffness or weakness may persist.

Complications

• Delayed or failed healing (nonunion)
• Infection, particularly if surgery is required
• Nerve or blood vessel damage
• Chronic pain or arthritis in the wrist or elbow
• Reduced range of motion or strength in the affected arm

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Maintain a balanced diet rich in calcium and vitamin D to support bone health
• Quit smoking, as it impairs bone healing
• Use protective gear during sports or activities with fall risks
• Follow post-treatment guidelines for immobilization and activity restrictions

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or deformity after an injury, or if you notice numbness, tingling, or loss of circulation in the hand. For follow-up care, contact your provider if pain worsens, swelling increases, or you suspect the fracture is not healing properly.

Tips for Medical Coders

Document the encounter as a "subsequent" visit for a closed fracture with nonunion. Ensure clinical notes specify the fracture type (nondisplaced segmental), location (shaft of radius, left arm), and the presence of nonunion. Include details on treatment provided and any imaging results to support the diagnosis and code selection.