S62.014K Nondisplaced fracture of distal pole of navicular [scaphoid] bone of right wrist, subsequent encounter for fracture with nonunion

Name of the Condition

• Nondisplaced fracture of distal pole of navicular [scaphoid] bone of right wrist, subsequent encounter for fracture with nonunion

Summary

A nondisplaced fracture of the distal pole of the navicular (scaphoid) bone in the right wrist involves a break in the lower portion of this small, critical wrist bone where the bone fragments remain in their normal alignment. This code specifies a subsequent encounter for a fracture with nonunion, indicating the fracture has not healed properly after an initial injury. The scaphoid plays a key role in wrist stability and movement, so persistent nonunion requires evaluation to determine appropriate management.

Causes

Typically results from trauma, such as a fall onto an outstretched hand (FOOSH) or direct impact to the wrist. Nonunion may develop due to inadequate immobilization, poor blood supply to the scaphoid, or delayed treatment of the initial fracture. High-force activities, twisting injuries, or accidents involving the wrist can also contribute to this condition.

Risk Factors

• Participation in contact sports or activities with a high risk of falls or wrist trauma.
• Osteoporosis or weakened bone structure, particularly in older adults.
• Previous wrist injuries or fractures that may compromise bone integrity.
• Engaging in activities with a risk of direct wrist impact or high-force stress.
• Smoking or other factors that impair bone healing.

Symptoms

• Persistent pain and tenderness localized to the wrist, especially near the base of the thumb.
• Swelling and bruising around the wrist area that may not resolve over time.
• Decreased range of motion or difficulty gripping objects.
• Possible numbness or tingling if nerves are affected.
• Visible deformity or instability in the wrist in severe cases.

Diagnosis

Physical examination to assess pain, swelling, and wrist mobility. Imaging tests, such as X-rays, CT scans, or MRI, are used to confirm the fracture and evaluate for nonunion. Additional assessments may include bone scans or ultrasound to assess blood flow and healing potential. Clinical history of prior fracture and treatment is also considered.

Treatment Options

Treatment depends on the severity of nonunion and patient factors. Options may include prolonged immobilization with a cast or brace, surgical intervention (e.g., bone grafting, internal fixation), or physical therapy to restore function. Pain management and activity modification are often part of the plan. In some cases, further imaging or specialist consultation is required.

Prognosis and Follow-Up

Prognosis varies based on the extent of nonunion and treatment response. Some fractures may heal with conservative management, while others require surgery. Regular follow-up with imaging is typically needed to monitor healing. Long-term outcomes may include persistent pain or reduced wrist function if nonunion persists. Rehabilitation and activity modification are often necessary to prevent further injury.

Complications

• Chronic pain or discomfort in the wrist.
• Reduced range of motion or stiffness.
• Increased risk of arthritis in the wrist joint.
• Nerve damage leading to numbness or weakness.
• Potential for future fractures due to weakened bone structure.
• Surgical complications, such as infection or hardware issues, if intervention is required.

Lifestyle & Prevention

• Avoid high-impact activities or sports that stress the wrist until cleared by a healthcare provider.
• Use protective gear (e.g., wrist guards) during activities with a risk of falls.
• Maintain bone health through a balanced diet rich in calcium and vitamin D.
• Quit smoking or reduce exposure to factors that impair healing.
• 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 in the wrist after an injury. Consult a healthcare provider if pain persists beyond initial treatment, or if you notice numbness, tingling, or difficulty moving the wrist. Follow up with a specialist if nonunion is suspected or if symptoms worsen over time.

Tips for Medical Coders

This code is used for a subsequent encounter for a nondisplaced fracture of the distal pole of the navicular (scaphoid) bone of the right wrist with nonunion. Documentation should specify the fracture site, laterality (right), and the presence of nonunion. Ensure the encounter is classified as "subsequent" and that the fracture is confirmed as nondisplaced. Include details of prior treatment and current clinical status to support the code assignment.