S72.062K Displaced articular fracture of head of left femur, subsequent encounter for closed fracture with nonunion

Name of the Condition

• Displaced articular fracture of head of left femur, subsequent encounter for closed fracture with nonunion

Summary

A displaced articular fracture of the head of the left femur involves a break in the femoral head (the rounded upper portion of the thigh bone that forms part of the hip joint) with the fracture fragments shifted out of their normal alignment. This injury disrupts joint mechanics and may result from trauma or weakened bone structure. The fracture is classified as closed (no open wound) and is documented as a subsequent encounter, indicating follow-up care for a fracture that has failed to heal (nonunion) after an initial episode of treatment.

Causes

High-impact trauma, such as falls or motor vehicle accidents. Low-impact trauma in individuals with weakened bones (e.g., osteoporosis). Direct force to the hip region. Nonunion may result from inadequate immobilization, poor blood supply to the fracture site, or infection.

Risk Factors

• Advanced age, particularly in those over 65
• Osteoporosis or other bone density disorders
• Female gender, due to higher osteoporosis prevalence
• History of prior fractures or bone diseases
• Participation in high-risk activities (e.g., contact sports)
• Conditions that impair bone healing (e.g., diabetes, smoking)

Symptoms

• Persistent hip or groin pain
• Inability to bear weight on the affected leg
• Swelling, bruising, or tenderness around the hip
• Leg shortening or external rotation of the affected limb
• Limited range of motion in the hip joint
• Possible clicking or grinding sensation during movement

Diagnosis

Physical examination to assess pain, mobility, and limb alignment. Imaging studies, including X-rays or CT scans, to visualize the fracture and confirm nonunion. Additional tests (e.g., MRI) may be used to evaluate blood supply or soft tissue involvement.

Treatment Options

• Immobilization with a brace or cast to stabilize the fracture
• Surgical intervention, such as internal fixation or hip replacement, to promote healing or restore function
• Bone grafting to stimulate union in cases of nonunion
• Physical therapy to improve strength and mobility after healing

Prognosis and Follow-Up

Prognosis depends on the severity of the fracture, patient age, and response to treatment. Nonunion may require extended follow-up and additional interventions. Regular monitoring with imaging is necessary to assess healing progress. Long-term outcomes may include chronic pain or reduced mobility if the fracture does not fully heal.

Complications

• Chronic pain or arthritis in the hip joint
• Avascular necrosis (loss of blood supply to the femoral head)
• Infection, particularly if surgery is performed
• Persistent nonunion or malunion
• Reduced mobility or disability

Lifestyle & Prevention

• Maintain bone health through adequate calcium and vitamin D intake
• Engage in weight-bearing exercise to strengthen bones
• Use fall prevention strategies, such as removing tripping hazards at home
• Avoid high-risk activities that increase fracture risk
• Manage underlying conditions (e.g., osteoporosis) with medical guidance

When to Seek Professional Help

Seek immediate medical attention for severe hip pain, inability to bear weight, or visible deformity. Follow up with a healthcare provider if pain persists, swelling worsens, or mobility does not improve after initial treatment.

Tips for Medical Coders

Document the laterality (left femur), fracture type (displaced articular), encounter stage (subsequent), and healing status (nonunion) to accurately assign this code. Ensure clinical documentation specifies the fracture as closed and confirms nonunion, as these details are critical for correct coding.