Name of the Condition

• Displaced comminuted fracture of the left patella, subsequent encounter for closed fracture with nonunion

Summary

• This condition entails a complex fracture of the kneecap (patella) in which the bone is broken into several pieces and displaced. It refers to a follow-up situation where the fracture has not healed properly (nonunion), requiring further medical assessment and potentially different treatment approaches.

Causes

• The primary cause of this type of fracture is direct trauma to the knee area, typically resulting from falls, collisions, or car accidents.

Risk Factors

• Risk factors include participating in high-impact sports, osteopenia or osteoporosis, occupation-related risk of knee injuries, and history of previous knee injuries or surgeries.

Symptoms

• Common symptoms are severe pain in the knee, swelling, inability to straighten the leg or walk properly, visible deformity of the knee, and tenderness around the kneecap.

Diagnosis

• Diagnosis typically involves a physical examination and imaging tests like X-rays or CT scans to ascertain the fracture's extent and monitor healing progress.

Treatment Options

• Treatment may include immobilization with a knee brace or cast, pain management, and potentially surgical intervention to realign and repair the broken bone fragments. Surgery might involve pins, screws, or wires to stabilize the fracture and promote healing.

Prognosis and Follow-Up

• The prognosis varies based on treatment effectiveness and patient health. Regular follow-up visits to monitor bone healing are crucial, as is adherence to rehabilitation protocols to regain knee function.

Complications

• Without proper management, complications can include chronic pain, persistent nonunion or malunion, decreased knee function, and arthritis.

Lifestyle & Prevention

• Preventive measures include using protective gear during activities, maintaining bone health through a balanced diet and supplements if needed, engaging in safe exercise practices, and using mobility aids to prevent falls in high-risk individuals.

When to Seek Professional Help

• Seek immediate medical attention if experiencing sharp knee pain after an injury, inability to bear weight on the leg, visible deformity, or if there is significant swelling and bruising.

Additional Resources

• American Academy of Orthopaedic Surgeons (AAOS): orthoinfo.aaos.org
• National Osteoporosis Foundation: nof.org

Tips for Medical Coders

• Ensure precise documentation of the fracture's characteristics (displaced, comminuted, nonunion) and the specific encounter type. Verify the correct side (left) and confirm that all associated codes for additional injuries or treatments are recorded. Avoid confusing subsequent encounter codes with initial or sequela codes.