S82.865 Nondisplaced Maisonneuve's fracture of left leg

Name of the Condition

• Nondisplaced Maisonneuve's fracture of left leg
• ICD-10 Code: S82.865

Summary

A Maisonneuve's fracture is a specific type of ankle injury involving a fracture of the proximal fibula (upper portion of the smaller lower leg bone) combined with a tear of the syndesmotic ligaments and often an associated injury to the medial malleolus or deltoid ligament. The term "nondisplaced" indicates that the fractured bone fragments remain aligned. This injury typically results from rotational forces applied to the ankle, commonly seen in trauma such as falls or sports injuries.

Causes

The fracture is caused by external rotational forces applied to the ankle, often during activities that involve twisting or turning. Common scenarios include falls, motor vehicle accidents, or sports-related impacts where the foot is planted and the body rotates forcefully. The mechanism typically involves the talus rotating outward, stressing the syndesmotic ligaments and causing the proximal fibula to fracture.

Risk Factors

• Participation in activities with high rotational stress on the ankle, such as soccer or basketball.
• Previous ankle injuries or ligamentous instability.
• Improper footwear or uneven terrain increasing fall risk.
• Age-related factors that may affect bone density or ligament integrity.

Symptoms

• Pain and swelling localized to the proximal fibula and ankle.
• Difficulty bearing weight on the affected leg.
• Instability or a feeling of the ankle "giving way."
• Bruising or tenderness along the lower leg.

Diagnosis

Diagnosis involves a physical examination to assess ankle stability, tenderness, and swelling. Imaging, typically X-rays, is used to identify the proximal fibula fracture and associated injuries. Additional imaging, such as CT or MRI, may be required to evaluate ligamentous damage or subtle fractures. The nondisplaced nature of the fracture is confirmed by the alignment of bone fragments on imaging.

Treatment Options

Treatment depends on the severity of associated ligamentous or bony injuries. Nondisplaced fractures may be managed with immobilization (e.g., casting or bracing) and protected weight-bearing. Surgical intervention may be necessary if there is significant syndesmotic instability or associated fractures. Physical therapy is often recommended to restore strength and mobility.

Prognosis and Follow-Up

With appropriate treatment, most patients recover fully, though recovery time may vary. Follow-up imaging and clinical assessments are important to monitor healing and address any residual instability. Long-term outcomes depend on the extent of associated ligamentous damage and adherence to rehabilitation.

Complications

• Persistent ankle instability or recurrent sprains.
• Delayed union or nonunion of the fibula fracture.
• Post-traumatic arthritis due to joint damage.
• Nerve or vascular injury in severe cases.

Lifestyle & Prevention

• Wear supportive footwear appropriate for activity.
• Use ankle braces or tape during high-risk sports.
• Improve ankle strength and proprioception through exercise.
• Avoid uneven surfaces or activities with high rotational stress when possible.

When to Seek Professional Help

Seek immediate medical attention for severe pain, inability to bear weight, visible deformity, or signs of nerve/vascular compromise (e.g., numbness, discoloration). Follow up with a healthcare provider if symptoms worsen or fail to improve with initial treatment.

Tips for Medical Coders

Document the nondisplaced nature of the Maisonneuve's fracture and specify the left leg. Include details of associated injuries (e.g., syndesmotic tear, medial malleolus injury) to support coding accuracy. Ensure documentation aligns with the clinical findings and imaging results.