Name of the Condition

• Displaced bicondylar fracture of left tibia, closed. Also known as a bicondylar plateau fracture of the tibia.

Summary

• A displaced bicondylar fracture of the left tibia refers to a specific type of break involving the upper part of the tibia (shinbone) near the knee joint, affecting both lateral and medial condyles. This kind of fracture is characterized by the misalignment of the bone ends and is categorized as a closed fracture, indicating the skin around the fracture remains intact.

Causes

• Common causes include high-energy trauma such as car accidents, falls from a significant height, or severe sports injuries that exert a strong force on the knee joint.

Risk Factors

• Risk factors include engaging in high-impact sports, osteoporosis, older age, occupations involving significant physical activity, and previous knee injuries.

Symptoms

• Symptoms typically include intense pain near the knee, swelling, bruising, inability to bear weight, and deformity or instability of the knee joint.

Diagnosis

• The condition is diagnosed through a combination of physical examination and imaging tests. X-rays are used to confirm the fracture, while CT scans may be employed to assess the extent and specific nature of the fracture more precisely.

Treatment Options

• Treatment often includes immobilization with a cast or brace if the fracture is stable. More severe cases require surgical intervention to realign the bone fragments using plates, screws, or rods. Post-surgical rehabilitation and physical therapy are essential for recovery.

Prognosis and Follow-Up

• With appropriate treatment, the prognosis for tibial plateau fractures is generally good, though recovery may take several months. Regular follow-up appointments are crucial to monitor healing and prevent complications like joint stiffness or arthritis.

Complications

• Potential complications include chronic pain, knee instability, post-traumatic arthritis, and limited range of motion if not adequately managed.

Lifestyle & Prevention

• Preventive measures focus on maintaining bone health through a balanced diet rich in calcium and vitamin D, regular weight-bearing exercises, and using protective gear when engaging in high-risk activities.

When to Seek Professional Help

• Immediate medical attention is required if there is severe knee pain, visible deformity, inability to move the knee, excessive swelling or bruising, or if the patient is unable to bear weight on the affected leg.

Additional Resources

• American Academy of Orthopaedic Surgeons (AAOS) (https://www.aaos.org/)
• Orthopaedic Trauma Association (OTA) (https://ota.org/)

Tips for Medical Coders

• Ensure to specify the side (left tibia) and condition (displaced, closed fracture) in the coding.
• Double-check the encounter type (initial) to accurately code it as S82.142A.
• Be aware of common errors such as miscoding the side or the nature of the fracture (open vs. closed).