S62.173K Displaced fracture of trapezium [larger multangular], unspecified wrist, subsequent encounter for fracture with nonunion

Name of the Condition

• Displaced fracture of trapezium [larger multangular], unspecified wrist, subsequent encounter for fracture with nonunion

Summary

This condition involves a displaced fracture of the trapezium bone in the wrist, where the bone fragments have not healed properly (nonunion) during a subsequent encounter. The trapezium is a carpal bone at the base of the thumb, and its fracture can impair wrist and thumb function. Displacement means the bone fragments are misaligned, and nonunion indicates the fracture has failed to unite after an expected healing period.

Causes

Typically caused by direct trauma to the wrist, such as a fall onto an outstretched hand, a blow to the thumb or wrist, or a crushing injury. High-impact activities or accidents may also lead to fractures in this area. Nonunion can result from inadequate immobilization, poor blood supply to the bone, or severe initial displacement.

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.
• Smoking or other factors that impair bone healing.

Symptoms

• Persistent pain, swelling, and tenderness at the base of the thumb.
• Bruising or discoloration around the injury site.
• Limited range of motion or difficulty moving the thumb.
• Visible deformity in severe cases.
• Possible clicking or grinding sensations during thumb movement.

Diagnosis

Physical examination to assess pain, swelling, and thumb mobility. Imaging tests, such as X-rays, CT scans, or MRIs, to confirm the fracture, evaluate displacement, and assess for nonunion. Additional tests may be used to rule out infection or other complications.

Treatment Options

• Surgical intervention: May be required to realign the bone fragments and promote healing, such as open reduction and internal fixation (ORIF) or bone grafting.
• Immobilization: Use of a cast or splint to stabilize the wrist and thumb during healing.
• Physical therapy: To restore strength and mobility after treatment.
• Pain management: Medications or other therapies to control discomfort.

Prognosis and Follow-Up

Prognosis depends on the severity of the fracture, treatment success, and patient factors. Nonunion may require additional interventions. Regular follow-up with imaging is often necessary to monitor healing. Long-term outcomes can include reduced mobility or chronic pain if the fracture does not fully heal.

Complications

• Chronic pain or stiffness in the wrist or thumb.
• Arthritis or joint damage due to improper healing.
• Nerve or tendon injury near the fracture site.
• Infection (if surgery is performed).

Lifestyle & Prevention

• Avoid high-impact activities that risk wrist injury.
• Use protective gear during sports or work.
• Maintain bone health through diet and exercise.
• Seek prompt treatment for wrist injuries to reduce nonunion risk.

When to Seek Professional Help

• Persistent pain, swelling, or deformity after an injury.
• Difficulty moving the thumb or wrist.
• Signs of infection, such as redness, warmth, or fever.
• New or worsening symptoms during recovery.

Tips for Medical Coders

Document the encounter as a subsequent visit for a fracture with nonunion. Include details on the fracture's location (trapezium), displacement, and the presence of nonunion. Note any surgical interventions or treatment plans. Ensure documentation supports the need for ongoing care and aligns with the code's specificity.