S62.162A Displaced fracture of pisiform, left wrist, initial encounter for closed fracture

Name of the Condition

• Displaced fracture of pisiform, left wrist, initial encounter for closed fracture

Summary

This condition involves a break in the pisiform bone, a small, pea-shaped carpal bone located on the palmar (palm) side of the left wrist, with displacement of bone fragments. The fracture is closed (skin intact) and represents the initial encounter for this injury. The pisiform is embedded within the flexor carpi ulnaris tendon and contributes to wrist stability. Displacement may affect alignment and require specific management to ensure proper healing.

Causes

Typically caused by direct trauma to the left wrist, such as a fall onto an outstretched hand, a blow to the palmar side of the wrist, or a crushing injury. High-impact activities or accidents may also lead to this type of fracture.

Risk Factors

• Participation in contact sports or activities with a high risk of falls.
• Osteoporosis or weakened bone structure, especially in older adults.
• Previous wrist injuries or fractures.

Symptoms

• Pain, swelling, and tenderness in the palmar side of the left wrist.
• Bruising or discoloration around the injury site.
• Limited range of motion or difficulty moving the hand or fingers.
• Visible deformity in severe cases.

Diagnosis

Physical examination to assess pain, swelling, and wrist mobility. Imaging tests, such as X-rays, CT scans, or MRIs, to confirm the fracture and evaluate its extent and alignment.

Treatment Options

• Immobilization: Using a cast, splint, or brace to stabilize the wrist and allow healing.
• Pain management: Medications to reduce pain and inflammation.
• Physical therapy: Exercises to restore strength and range of motion after healing.
• Surgical intervention: May be required for severe displacement or unstable fractures.

Prognosis and Follow-Up

Most fractures heal with proper immobilization and care, though recovery time varies. Follow-up appointments monitor healing progress, and physical therapy may be recommended to restore function. Complications are rare but possible with severe injuries.

Complications

• Delayed healing or nonunion of the fracture.
• Chronic pain or stiffness in the wrist.
• Nerve or tendon damage due to displacement.
• Post-traumatic arthritis in the wrist.

Lifestyle & Prevention

• Use protective gear during high-risk activities (e.g., sports).
• Maintain bone health through diet and exercise to reduce fracture risk.
• Avoid falls by using assistive devices if balance is impaired.

When to Seek Professional Help

Seek immediate medical attention if there is severe pain, swelling, deformity, or inability to move the wrist. Persistent pain or limited function after initial treatment also warrants evaluation.

Tips for Medical Coders

Document the side (left wrist), displacement status, and encounter type (initial for closed fracture) to accurately assign this code. Ensure clinical notes specify the fracture as closed and the pisiform bone involvement.