S82.152N Displaced fracture of left tibial tuberosity, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with nonunion

Name of the Condition

• Displaced fracture of left tibial tuberosity, subsequent encounter for open fracture type IIIA, IIIB, or IIIC 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 an open fracture (type IIIA, IIIB, or IIIC) with nonunion, indicating the fracture has not healed properly after previous treatment. Open fractures involve the bone piercing the skin, increasing infection risk, while nonunion refers to a failure of the bone to unite.

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. Open fractures occur when the broken bone penetrates the skin, and nonunion may result from inadequate immobilization, poor blood supply, or infection.

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
• High-impact trauma, such as falls or direct blows to the knee

Symptoms

• Severe 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
• Persistent pain or instability indicating nonunion

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 MRI or CT scans may be ordered to assess nonunion or soft tissue damage. Clinical history of prior treatment and open fracture status is critical for accurate coding.

Treatment Options

Treatment focuses on addressing nonunion and managing the open fracture. Options may include surgical intervention to realign and stabilize the bone, bone grafting to promote healing, or external fixation devices. Antibiotics are often required to prevent or treat infection. Physical therapy is typically recommended to restore function and strength.

Prognosis and Follow-Up

Prognosis depends on the severity of the fracture, infection status, and response to treatment. Nonunion may require prolonged healing time or additional procedures. Regular follow-up with imaging is necessary to monitor bone healing. Physical therapy and activity modification are often needed to regain mobility and prevent recurrence.

Complications

• Infection, particularly with open fractures
• Chronic pain or instability
• Delayed union or nonunion
• Arthritis or joint damage
• Nerve or vascular injury

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Use proper protective gear during sports
• Maintain bone health through nutrition and exercise
• Follow post-treatment guidelines to support healing

When to Seek Professional Help

Seek immediate medical attention for severe pain, swelling, or inability to bear weight. Contact a healthcare provider if symptoms worsen or if there are signs of infection, such as fever, redness, or drainage from the wound.

Tips for Medical Coders

This code is for a subsequent encounter of an open fracture (type IIIA, IIIB, or IIIC) with nonunion. Document the fracture type, nonunion status, and encounter type clearly. Ensure clinical notes specify the open fracture classification and evidence of nonunion to support accurate coding.