S82.152K Displaced fracture of left tibial tuberosity, subsequent encounter for closed fracture with nonunion

Name of the Condition

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

Summary

A displaced fracture of the left tibial tuberosity involves a break in the bony prominence on the anterior upper tibia where the patellar tendon attaches. Displacement means the bone fragments are misaligned, which may affect knee function. This code specifies a subsequent encounter for a closed fracture with nonunion, indicating the fracture has not healed properly after prior treatment. Nonunion refers to a failure of the bone to unite within the expected timeframe, often requiring additional intervention.

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, infection, 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

Symptoms

• Persistent pain and swelling over the tibial tuberosity, often lasting beyond the typical healing period
• Inability to fully extend the knee or bear weight on the affected limb
• Visible deformity or abnormal positioning of the knee due to unhealed fracture
• Bruising or tenderness that does not improve with time

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 bone healing and detect nonunion. Clinical correlation with prior treatment history is essential to determine the appropriate encounter type.

Treatment Options

Treatment focuses on promoting bone union 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 improve mobility and strength once healing progresses.

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 long-term stiffness or weakness. Regular follow-up with imaging is necessary to monitor healing. Adjustments to treatment plans may be made based on progress or lack thereof.

Complications

• Chronic pain or instability in the knee
• Limited range of motion or difficulty bearing weight
• Increased risk of future fractures due to weakened bone
• Potential need for additional surgeries if nonunion persists

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Follow prescribed rehabilitation plans to support healing
• Maintain a balanced diet rich in calcium and vitamin D to support bone health
• Use protective gear during sports or activities with fall risks

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or inability to move the knee after an injury. Contact your provider if symptoms worsen or do not improve with treatment, as this may indicate nonunion or other complications.

Tips for Medical Coders

This code is used for a subsequent encounter for a closed fracture with nonunion of the left tibial tuberosity. Document the encounter type (subsequent) and confirm the fracture is closed (no skin penetration) with evidence of nonunion. Ensure clinical documentation supports the diagnosis and encounter timing to justify code assignment.