S72.335K Nondisplaced oblique fracture of shaft of left femur, subsequent encounter for closed fracture with nonunion

Name of the Condition

• Nondisplaced Oblique Fracture of Shaft of Left Femur, Subsequent Encounter for Closed Fracture with Nonunion

Summary

A nondisplaced oblique fracture of the shaft of the left femur is a break in the long, central portion of the thigh bone where the fracture line runs at an angle, and the bone fragments remain aligned. This type of fracture involves the diaphysis (main structural part) of the femur and is classified as closed, meaning the overlying skin is intact. The subsequent encounter indicates ongoing care for this specific injury, and the presence of nonunion indicates the fracture has not healed within the expected timeframe.

Causes

Such fractures often result from high-impact trauma, such as motor vehicle accidents, falls from significant heights, or direct blows to the thigh. Rotational forces or axial loading (e.g., during sports or industrial injuries) can also cause this type of break. Nonunion may develop due to inadequate immobilization, poor blood supply to the fracture site, infection, or other factors that impede healing.

Risk Factors

• Participation in high-impact sports or activities.
• Osteoporosis or other bone-weakening conditions.
• Advanced age, due to decreased bone density.
• Prior history of fractures or bone abnormalities.
• Trauma or accidents involving significant force.
• Smoking or poor nutrition, which can affect bone healing.
• Certain medical conditions, such as diabetes or vascular disease.

Symptoms

• Persistent or recurrent pain at the fracture site.
• Swelling, bruising, or tenderness around the fracture site.
• Inability to bear weight on the affected leg.
• Possible deformity or instability if nonunion progresses.
• Limited range of motion in the hip or knee.

Diagnosis

Physical examination to assess pain, alignment, and function. Imaging tests such as X-rays to visualize the fracture and assess healing progress. Additional tests, like CT scans or bone scans, may be used to evaluate nonunion or assess blood flow to the fracture site.

Treatment Options

Treatment may include immobilization with a cast or brace to stabilize the fracture. Surgical intervention, such as internal fixation with plates or screws, may be necessary to promote healing. Bone grafting or electrical stimulation may be used to encourage union in cases of nonunion. Physical therapy is often recommended to restore strength and mobility.

Prognosis and Follow-Up

Prognosis depends on the severity of the nonunion and the effectiveness of treatment. Regular follow-up with imaging is typically required to monitor healing. Full recovery may take several months, and some patients may experience long-term limitations in mobility or function.

Complications

• Delayed or failed healing (nonunion).
• Infection, particularly if surgical intervention is required.
• Nerve or blood vessel damage near the fracture site.
• Chronic pain or arthritis in the affected joint.
• Muscle atrophy or weakness due to prolonged immobilization.

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider.
• Maintain a balanced diet rich in calcium and vitamin D to support bone health.
• Quit smoking, as it can impair bone healing.
• Use protective equipment during sports or activities with a risk of injury.
• Follow post-treatment guidelines for weight-bearing and activity restrictions.

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or deformity at the fracture site. Contact your healthcare provider if you notice increased pain, signs of infection (e.g., redness, warmth, fever), or if the fracture does not appear to be healing as expected.

Tips for Medical Coders

Document the encounter as a subsequent visit for a closed fracture with nonunion. Ensure the fracture is described as nondisplaced and oblique, involving the shaft of the left femur. Note the absence of displacement and the presence of nonunion to support the code. Include details about the fracture's stability and any treatments provided during the encounter.