S72.024K Nondisplaced fracture of epiphysis (separation) (upper) of right femur, subsequent encounter for closed fracture with nonunion

Name of the Condition

• Nondisplaced fracture of epiphysis (separation) (upper) of right femur, subsequent encounter for closed fracture with nonunion

Summary

This condition represents a nondisplaced fracture of the growth plate (epiphysis) in the upper right femur, where the epiphysis remains aligned with the bone but has failed to heal (nonunion) during a subsequent encounter. The fracture is closed, meaning the skin is intact. This code is used when evaluating or treating a previously diagnosed fracture that has not united, requiring ongoing management to address healing failure.

Causes

High-impact trauma, such as falls, sports injuries, or motor vehicle accidents. Direct force to the hip or thigh region. Nonunion may result from inadequate immobilization, poor blood supply, or excessive movement at the fracture site.

Risk Factors

• Adolescence, as growth plates are more vulnerable during development
• Participation in high-impact activities or contact sports
• Underlying bone conditions that weaken structural integrity
• Previous fractures or delayed treatment

Symptoms

• Persistent pain and swelling in the hip or thigh area
• Difficulty bearing weight on the affected leg
• Bruising or tenderness at the injury site
• Limited range of motion in the hip joint
• Possible instability or clicking sensations

Diagnosis

Physical examination to assess pain, swelling, and mobility. Imaging studies, such as X-rays or MRI, to visualize the fracture and confirm nonunion. Evaluation of healing progress and alignment to determine if intervention is needed.

Treatment Options

• Immobilization with casting or bracing to promote healing
• Surgical intervention, such as bone grafting or fixation, if nonunion persists
• Physical therapy to restore strength and mobility after healing
• Monitoring for signs of infection or further complications

Prognosis and Follow-Up

Recovery depends on the severity of the nonunion and response to treatment. Regular follow-up imaging and clinical assessments are necessary to monitor healing. Some cases may require long-term management to address functional limitations.

Complications

• Chronic pain or instability
• Avascular necrosis (loss of blood supply to the bone)
• Malalignment or deformity
• Increased risk of future fractures
• Reduced mobility or functional impairment

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Follow prescribed immobilization and weight-bearing restrictions
• Maintain a balanced diet rich in calcium and vitamin D to support bone health
• Use protective gear during sports or high-risk activities

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or inability to bear weight, or if symptoms worsen despite treatment. Contact your provider if you notice signs of infection, such as redness, warmth, or drainage.

Tips for Medical Coders

Document the encounter as a subsequent visit for a closed fracture with nonunion. Include details on the fracture’s location (upper right femur), alignment (nondisplaced), and healing status (nonunion). Ensure the encounter type (subsequent) and fracture characteristics (closed) are clearly recorded to support accurate coding.