S82.153K Displaced fracture of unspecified tibial tuberosity, subsequent encounter for closed fracture with nonunion

Name of the Condition

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

Summary

A displaced fracture of the tibial tuberosity involves a break in the bony prominence on the anterior tibia where the patellar tendon attaches. Displacement means the bone fragments are misaligned. This code specifies a subsequent encounter for a closed fracture with nonunion, indicating the fracture has not healed properly after prior treatment and the skin remains intact.

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, 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 affecting bone healing

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
• Possible clicking or grinding sensation with movement

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 surrounding tissues. Clinical history of prior treatment and healing progress is also considered.

Treatment Options

Treatment may include surgical intervention to realign and stabilize the fracture, such as internal fixation with screws or plates. Bone grafting may be necessary to promote healing. Physical therapy is often recommended to restore function and strength. Pain management and activity modification are also part of the care plan.

Prognosis and Follow-Up

Prognosis depends on the severity of the nonunion and response to treatment. Follow-up imaging and clinical assessments are typically scheduled to monitor healing. Long-term outcomes may include residual pain or limited mobility, but most patients can return to normal activities with appropriate care.

Complications

• Chronic pain or instability in the knee
• Limited range of motion
• Risk of future fractures due to weakened bone
• Infection (if surgical intervention is required)
• Nerve or blood vessel damage in severe cases

Lifestyle & Prevention

• Avoid high-impact activities until cleared by a healthcare provider
• Use proper protective gear during sports
• Maintain a healthy diet rich in calcium and vitamin D to support bone health
• Follow rehabilitation guidelines to ensure proper healing
• Gradually return to activity to prevent re-injury

When to Seek Professional Help

Seek medical attention if you experience severe pain, swelling, or inability to bear weight after a knee injury. Consult a healthcare provider if symptoms persist or worsen despite initial treatment, or if you notice deformity or instability in the knee.

Tips for Medical Coders

This code is used for a subsequent encounter of a closed fracture with nonunion. Document the fracture type, encounter stage, and healing status clearly. Ensure the record specifies "closed" and "nonunion" to support accurate coding. Include details on prior treatments and current clinical findings to justify the diagnosis.