S79.129 Salter-Harris Type II physeal fracture of lower end of unspecified femur

Name of the Condition

Salter-Harris Type II physeal fracture of lower end of unspecified femur

Summary

A Salter-Harris Type II physeal fracture of the lower end of the unspecified femur is an injury involving the growth plate (physis) at the distal femur, typically occurring in children or adolescents. This fracture disrupts the physis, which is the area of developing bone responsible for longitudinal growth. The injury specifically involves a separation of the growth plate with a fracture through the metaphysis, as defined by the Salter-Harris classification system. The fracture line extends from the physis into the metaphysis, distinguishing it from Type I fractures.

Causes

Salter-Harris Type II physeal fractures of the lower femur are usually caused by acute trauma, such as falls, sports-related injuries, or direct blows to the knee or thigh. The force transmitted across the growth plate can cause it to separate from the adjacent bone, with the fracture extending into the metaphysis. In some cases, repetitive stress or overuse may contribute to the injury, particularly in active children or adolescents.

Risk Factors

• Age: Most common in children and adolescents, as growth plates are weaker than surrounding bone.
• Activity level: Participation in high-impact sports or activities with a risk of falls (e.g., gymnastics, soccer, skateboarding).
• Growth spurts: Periods of rapid growth may temporarily weaken the physis, increasing susceptibility to injury.
• Anatomical factors: Variations in bone structure or alignment may predispose to injury.

Symptoms

Symptoms typically include pain, swelling, and tenderness at the fracture site, often with visible deformity or inability to bear weight. The affected limb may appear shortened or misaligned, and movement of the knee or hip may be restricted. Bruising or discoloration around the injury area is common.

Diagnosis

Diagnosis is based on clinical evaluation and imaging studies. Physical examination reveals tenderness, swelling, and potential deformity. Radiographs (X-rays) of the femur and knee are standard to confirm the fracture type and assess displacement. In some cases, advanced imaging (e.g., MRI or CT) may be used to evaluate soft tissue damage or subtle fractures.

Treatment Options

Treatment depends on fracture severity and displacement. Nondisplaced fractures may be managed with immobilization (e.g., casting or bracing) and activity restriction. Displaced fractures often require closed reduction (realignment) or surgical intervention to restore alignment and stabilize the growth plate. Post-treatment, physical therapy may be recommended to restore function and strength.

Prognosis and Follow-Up

Prognosis is generally favorable with appropriate treatment, though outcomes depend on fracture severity and growth plate involvement. Regular follow-up with imaging is essential to monitor for growth disturbances or angular deformities. Most children recover fully, but long-term monitoring may be needed to assess limb length and alignment.

Complications

Potential complications include growth plate arrest (leading to limb length discrepancy or angular deformity), malunion, nonunion, or chronic pain. Infection or nerve damage may occur with surgical intervention. Early recognition and management reduce these risks.

Lifestyle & Prevention

Preventive measures include using protective gear during sports, ensuring proper training techniques, and avoiding high-risk activities without supervision. Maintaining bone health through adequate nutrition (e.g., calcium and vitamin D) supports growth plate strength. Prompt treatment of minor injuries reduces progression to severe fractures.

When to Seek Professional Help

Seek immediate medical attention for severe pain, visible deformity, inability to move the limb, or signs of infection (e.g., fever, redness, drainage). Delayed care may worsen outcomes, especially if the fracture is displaced or involves the growth plate.

Tips for Medical Coders

Use code S79.129 for Salter-Harris Type II physeal fractures of the lower end of the unspecified femur. Document the fracture location (unspecified femur) and confirm the Salter-Harris Type II classification. Include details on fracture displacement, treatment, and any associated injuries to support coding accuracy. Ensure documentation aligns with clinical findings and imaging results.