S72.042K Displaced fracture of base of neck of left femur, subsequent encounter for closed fracture with nonunion

Name of the Condition

• Displaced fracture of base of neck of left femur, subsequent encounter for closed fracture with nonunion (S72.042K)

Summary

This condition involves a break in the upper portion of the left femur (thigh bone) at the base of the femoral neck, near the hip joint, where the bone fragments have shifted out of their normal anatomical position. The term "subsequent encounter" indicates this is a follow-up visit for a previously treated fracture, and "closed fracture with nonunion" specifies that the fracture site has not healed properly despite the skin remaining intact (no open wound). This type of fracture typically affects the structural integrity of the hip joint and requires ongoing evaluation to address healing delays.

Causes

High-impact trauma, such as falls or motor vehicle accidents, is a common cause. In older adults, particularly those with weakened bone density (e.g., osteoporosis), fractures may occur from minor trauma or low-impact events. Direct force to the hip or thigh region can also result in this injury. Nonunion may develop due to inadequate immobilization, poor blood supply to the fracture site, infection, or underlying health conditions that impair healing.

Risk Factors

• Advanced age, especially in individuals over 65
• Osteoporosis or other bone-weakening conditions
• Female gender, due to higher osteoporosis prevalence
• History of prior fractures or bone diseases
• Participation in high-risk activities (e.g., contact sports)
• Smoking or poor nutrition, which can impair bone healing
• Certain medical conditions (e.g., diabetes, vascular disease) that affect circulation

Symptoms

• Persistent or worsening hip or groin pain
• Swelling, bruising, or tenderness around the hip
• Inability to bear weight on the affected leg
• Visible deformity or shortening of the leg
• Limited range of motion in the hip joint
• Sensation of the bone shifting or not healing

Diagnosis

Physical examination to assess pain, swelling, and range of motion, followed by imaging studies (e.g., X-rays, CT scans, or MRI) to evaluate fracture alignment and healing progress. Additional tests, such as bone density scans or blood work, may be used to identify underlying conditions contributing to nonunion. Documentation should confirm the fracture type, location, and lack of healing.

Treatment Options

Treatment focuses on promoting fracture union and restoring function. Options may include surgical intervention (e.g., internal fixation, bone grafting) to stabilize the fracture, or non-surgical methods (e.g., bracing, physical therapy) for less severe cases. Pain management and addressing underlying conditions (e.g., osteoporosis) are also key components of care.

Prognosis and Follow-Up

Prognosis depends on the severity of the fracture, patient health, and treatment adherence. Nonunion may require extended healing time or additional procedures. Regular follow-up appointments with imaging are necessary to monitor progress. Most patients can regain mobility with appropriate treatment, though some may experience long-term limitations.

Complications

• Chronic pain or discomfort
• Reduced mobility or disability
• Avascular necrosis (loss of blood supply to the femoral head)
• Infection (if surgical intervention is required)
• Need for additional surgeries
• Long-term joint damage or arthritis

Lifestyle & Prevention

• Maintain a balanced diet rich in calcium and vitamin D to support bone health.
• Engage in weight-bearing exercises to strengthen bones.
• Use assistive devices (e.g., canes, walkers) to prevent falls, especially in older adults.
• Avoid high-risk activities that increase fracture risk.
• Manage underlying conditions (e.g., osteoporosis) with medical guidance.

When to Seek Professional Help

Seek immediate care if you experience severe hip pain, inability to bear weight, or signs of infection (e.g., fever, redness, drainage). Follow up with your healthcare provider if pain persists, swelling worsens, or you notice decreased mobility after treatment.

Tips for Medical Coders

Document the fracture location (left femur, base of neck), displacement, encounter type (subsequent), and healing status (nonunion) clearly. Ensure the fracture is classified as closed (no open wound) and specify the nonunion to support accurate coding. Include details on treatment approaches and any contributing factors (e.g., osteoporosis) to reflect the complexity of the case.