Name of the Condition

• Nondisplaced fracture of proximal phalanx of left index finger, initial encounter for open fracture
• Technical term: S62.641B

Summary

• This medical condition refers to a break in the proximal phalanx (the bone closest to the hand) of the left index finger. The fracture has not displaced, meaning the bone pieces have not significantly moved. Being an open fracture, the skin has been broken, exposing the bone to potential contamination. This is the initial medical encounter for this injury.

Causes

• Common causes include direct trauma or impact injury to the hand, such as hitting a hard object, sports injuries, or accidents involving machinery or tools.

Risk Factors

• Active participation in contact sports or high-risk occupations.
• A history of falls or conditions like osteoporosis that weaken the bones.
• Inadequate protective gear during high-impact activities.

Symptoms

• Pain and tenderness at the site of injury.
• Swelling and bruising around the affected area.
• Reduced ability to move the index finger or gripping difficulties.
• Visible wound over the fracture site due to it being an open fracture.

Diagnosis

• Physical examination to assess swelling, bruising, and range of motion.
• Imaging tests, primarily X-rays, to confirm the fracture and check alignment.
• Evaluation of the open wound to assess contamination risk or additional damage.

Treatment Options

• Immobilization using a splint or cast to ensure healing.
• Cleaning and possible debridement of the wound to prevent infection.
• Pain management with NSAIDs or prescribed pain relief.
• Follow-up imaging to monitor bone healing.
• In some cases, surgical intervention may be necessary to fixate the bone.

Prognosis and Follow-Up

• Most nondisplaced proximal phalanx fractures heal well with proper treatment.
• Regular follow-ups are essential to monitor bone healing and prevent infection due to the open fracture.
• Physical therapy may be needed to restore movement and strength once initial healing has occurred.

Complications

• Risk of infection, particularly due to the open nature of the fracture.
• Delayed healing if the bone does not remain properly aligned.
• Long-term stiffness or reduced range of motion in the finger.

Lifestyle & Prevention

• Use protective gloves or gear when engaging in high-risk activities.
• Ensure a safe environment to reduce falls and accidents.
• Maintain good bone health through a balanced diet rich in calcium and vitamin D.

When to Seek Professional Help

• Intense, persistent pain or swelling despite initial treatment.
• Signs of infection, such as increased redness, warmth, or discharge from the wound.
• Loss of movement or inability to perform daily activities with the hand.

Additional Resources

• American Academy of Orthopaedic Surgeons (AAOS) for information on fractures.
• “OrthoInfo” by AAOS for patient education on hand and upper extremity injuries.

Tips for Medical Coders

• Ensure correct identification of the fracture as nondisplaced and open.
• Verify that this is coded as an initial encounter (B qualifier).
• Be cautious not to confuse with similar codes for displaced fractures or other phalangeal bones.