S82.151K Displaced fracture of right tibial tuberosity, subsequent encounter for closed fracture with nonunion

Name of the Condition

• Displaced fracture of right tibial tuberosity, subsequent encounter for closed fracture with nonunion

Summary

A displaced fracture of the right tibial tuberosity involves a break in the bony prominence on the anterior upper tibia where the patellar tendon attaches. This specific ICD code refers to a subsequent encounter for a closed fracture with nonunion, meaning the bone fragments remain misaligned and have failed to heal properly after an initial injury. Nonunion indicates the fracture site has not consolidated, which may affect knee function and stability.

Causes

Traumatic injury is the primary cause, such as direct impact to the knee, falls, or sudden forceful contraction of the quadriceps muscle. Sports-related incidents, motor vehicle accidents, or other high-impact events can lead to this fracture. Nonunion may result from inadequate immobilization, poor blood supply to the fracture site, or excessive movement during healing.

Risk Factors

• Participation in activities with rapid knee extension or jumping (e.g., basketball, soccer)
• Adolescent growth spurts, especially in athletes
• Previous knee injuries or surgeries
• Osteoporosis or bone-weakening conditions
• Smoking or poor nutrition, which can impair bone healing
• Inadequate initial treatment or noncompliance with immobilization

Symptoms

• Persistent pain and swelling over the tibial tuberosity
• Inability to fully extend the knee or bear weight
• Visible deformity or abnormal positioning of the knee
• Bruising or discoloration in the affected area
• Sensation of instability or "giving way" in the knee

Diagnosis

Diagnosis involves a physical examination to assess pain, swelling, and deformity. Imaging studies, such as X-rays, are used to confirm the fracture and evaluate displacement. Additional tests like CT scans or MRI may be ordered to assess nonunion and soft tissue damage. Bone healing progress is evaluated through serial imaging to determine if consolidation has occurred.

Treatment Options

Treatment focuses on promoting bone healing and restoring function. Options may include surgical intervention, such as internal fixation with screws or plates, to stabilize the fracture. Non-surgical approaches, like prolonged immobilization or bone grafting, may be considered depending on the severity. Physical therapy is often recommended to restore strength and mobility after healing.

Prognosis and Follow-Up

Prognosis depends on the success of treatment and the extent of nonunion. With appropriate intervention, many patients achieve functional recovery, though some may experience residual pain or limited mobility. Regular follow-up with imaging is necessary to monitor healing progress. Long-term outcomes may include reduced athletic performance or chronic knee issues if healing is incomplete.

Complications

• Chronic pain or instability in the knee
• Persistent nonunion requiring additional surgery
• Arthritis or joint degeneration over time
• Infection (if surgical intervention is needed)
• Reduced range of motion or muscle weakness

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Follow prescribed immobilization and weight-bearing restrictions
• Engage in physical therapy to strengthen surrounding muscles
• Maintain a balanced diet rich in calcium and vitamin D to support bone health
• Use protective gear during sports to reduce injury risk

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or inability to bear weight after a knee injury. Contact your healthcare provider if symptoms worsen or fail to improve with treatment, or if you notice persistent instability or deformity in the knee.

Tips for Medical Coders

This code is used for a subsequent encounter of a closed fracture with nonunion. Document the encounter type (subsequent) and confirm the fracture is closed (no skin penetration) and nonunion (failure to heal). Ensure clinical notes specify the fracture location (right tibial tuberosity) and displacement. Use this code only when the encounter is for treatment of the nonunion, not the initial injury.