S82.865A Nondisplaced Maisonneuve's fracture of left leg, initial encounter for closed fracture

Name of the Condition

• Nondisplaced Maisonneuve's fracture of left leg, initial encounter for closed fracture

Summary

A Maisonneuve's fracture is a specific type of ankle injury involving a proximal fibula fracture combined with a tear of the tibiofibular syndesmosis and often an associated medial malleolus or deltoid ligament injury. The term "nondisplaced" indicates that the fractured bone fragments remain in their normal alignment. This injury typically results from rotational forces applied to the ankle, leading to instability in the ankle joint. The "initial encounter for closed fracture" specifies this is the first treatment for a fracture without an open wound.

Causes

The fracture is usually caused by external rotation of the foot, which can occur during activities like twisting the ankle, falls, or sports-related injuries. The rotational force disrupts the syndesmotic ligaments and may cause additional damage to the medial structures of the ankle.

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.

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 ligament damage or other subtle fractures. The nondisplaced nature of the fracture is confirmed by imaging showing no significant misalignment of bone fragments.

Treatment Options

Treatment focuses on stabilizing the ankle and allowing healing. Options may include immobilization with a cast or brace, pain management, and physical therapy to restore strength and mobility. Surgical intervention is less common for nondisplaced fractures but may be considered if instability persists.

Prognosis and Follow-Up

With proper treatment, most nondisplaced Maisonneuve's fractures heal well, though recovery may take several weeks to months. Follow-up care includes monitoring for healing progress and assessing ankle stability. Physical therapy is often recommended to prevent long-term weakness or instability.

Complications

Potential complications include chronic ankle instability, post-traumatic arthritis, or delayed healing. In rare cases, improper alignment or untreated ligament damage may lead to persistent pain or functional limitations.

Lifestyle & Prevention

• Wear supportive footwear during activities with high ankle stress.
• Use caution on uneven surfaces to reduce fall risk.
• Engage in exercises to strengthen ankle muscles and improve balance.
• Avoid sudden twisting motions that could strain the ankle.

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, inability to bear weight, visible deformity, or signs of infection (e.g., fever, redness, swelling). Persistent instability or pain after initial treatment also warrants evaluation.

Tips for Medical Coders

Document the nondisplaced nature of the fracture, the initial encounter status, and the closed fracture classification. Ensure the left leg laterality and Maisonneuve's fracture type are clearly specified in the medical record to support accurate coding.