S62.026A Nondisplaced fracture of middle third of navicular [scaphoid] bone of unspecified wrist, initial encounter for closed fracture

Name of the Condition

• Nondisplaced fracture of middle third of navicular [scaphoid] bone of unspecified wrist, initial encounter for closed fracture

Summary

This condition involves a break in the middle third of the navicular (scaphoid) bone, a small bone in the wrist near the base of the thumb. The fracture is nondisplaced, meaning the bone fragments remain in their normal alignment. It is classified as an initial encounter for a closed fracture, indicating the injury is recent and the skin is intact.

Causes

Typically results from a fall onto an outstretched hand (FOOSH). Can occur due to direct trauma to the wrist, such as a blow or impact. May also result from twisting injuries or high-impact activities that stress the wrist.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or weakened bone structure, particularly in older adults.
• Previous wrist injuries or fractures that may have compromised bone integrity.

Symptoms

• Pain and tenderness at the base of the thumb.
• Swelling and bruising around the wrist area.
• Limited wrist movement or difficulty gripping objects.
• Possible numbness or tingling if nerves are affected.

Diagnosis

Physical examination to assess pain, swelling, and wrist mobility. Imaging tests, such as X-rays, CT scans, or MRI, to visualize the fracture and confirm it is nondisplaced. Documentation must specify the fracture is closed and the encounter is initial.

Treatment Options

• Immobilization with a cast or splint to stabilize the bone.
• Pain management with medications.
• Close monitoring for healing, as scaphoid fractures may require extended immobilization.

Prognosis and Follow-Up

Healing time depends on the severity of the fracture and patient factors. Nondisplaced fractures often heal well with immobilization, but follow-up imaging may be needed to confirm union. Physical therapy may be recommended to restore function.

Complications

• Delayed healing or nonunion, especially if the fracture is not immobilized properly.
• Avascular necrosis (loss of blood supply to the bone) due to the scaphoid’s unique blood supply.
• Arthritis in the wrist joint over time if the fracture affects joint alignment.

Lifestyle & Prevention

• Use protective gear during high-risk activities (e.g., wrist guards in sports).
• Maintain bone health through adequate calcium and vitamin D intake.
• Avoid falls by using assistive devices if balance is impaired.

When to Seek Professional Help

Seek immediate care if pain is severe, swelling worsens, or there is numbness/tingling in the hand. Follow up with a healthcare provider if symptoms do not improve with initial treatment or if mobility does not return as expected.

Tips for Medical Coders

Document the fracture as nondisplaced, specify the middle third of the navicular bone, and confirm it is a closed fracture with an initial encounter. Ensure the wrist side (unspecified) is clearly noted, as this affects code assignment.