S92.322K Displaced fracture of second metatarsal bone, left foot, subsequent encounter for fracture with nonunion

Name of the Condition

• Technical Term: Displaced fracture of second metatarsal bone, left foot, subsequent encounter for fracture with nonunion
• ICD-10 Code: S92.322K
• Common Name: Broken second metatarsal (left foot, nonunion)

Summary

A displaced fracture of the second metatarsal bone in the left foot is a break where the bone fragments are out of alignment, occurring during a subsequent encounter for a fracture with nonunion. Nonunion means the bone has failed to heal properly after an initial injury. This condition may affect weight-bearing ability and mobility, and treatment often focuses on promoting healing or stabilizing the fracture.

Causes

Direct trauma to the left foot, such as a fall, sports injury, or heavy object impact, is the primary cause of the initial fracture. Nonunion can result from inadequate immobilization, poor blood supply to the bone, infection, or excessive movement during healing. Repetitive stress or delayed treatment may also contribute to the failure of the bone to unite.

Risk Factors

• Participation in high-impact sports (e.g., basketball, soccer)
• Wearing improper or non-supportive footwear
• Conditions that weaken bones, such as osteoporosis or diabetes
• Advanced age, which may reduce bone density and healing capacity
• Previous foot injuries or fractures
• Smoking, which impairs bone healing

Symptoms

• Persistent pain and tenderness in the midfoot (left foot)
• Swelling and bruising around the affected bone
• Difficulty bearing weight or walking
• Visible deformity or instability in the foot
• Possible clicking or grinding sensations with movement

Diagnosis

Diagnosis involves a physical examination to assess pain, swelling, and mobility. Imaging studies, such as X-rays or CT scans, are used to confirm the fracture, assess displacement, and identify nonunion. Additional tests, like bone scans or MRI, may be performed to evaluate blood flow and tissue damage. The healthcare provider will review the patient’s medical history and prior treatment to determine the cause of nonunion.

Treatment Options

Treatment depends on the severity of nonunion and patient factors. Options may include immobilization with a cast or brace to stabilize the fracture, surgical intervention to realign and fix the bone (e.g., with plates, screws, or bone grafts), or physical therapy to restore strength and mobility. Pain management and addressing underlying conditions (e.g., poor circulation) are also part of the plan.

Prognosis and Follow-Up

Prognosis varies based on the extent of nonunion and treatment response. With proper intervention, many patients achieve healing and improved function, but some may experience long-term mobility limitations. Follow-up appointments are necessary to monitor healing through imaging and adjust treatment as needed. Rehabilitation is often required to regain strength and prevent future injuries.

Complications

• Chronic pain or instability in the foot
• Arthritis or joint damage due to misalignment
• Infection, particularly if surgery is performed
• Nerve damage or numbness
• Difficulty returning to normal activities or sports

Lifestyle & Prevention

• Wear supportive, properly fitting footwear to reduce stress on the foot.
• Avoid high-impact activities until cleared by a healthcare provider.
• Maintain a healthy diet rich in calcium and vitamin D to support bone health.
• Quit smoking, as it impairs healing.
• Follow post-injury care instructions closely to promote proper healing.

When to Seek Professional Help

Seek immediate medical attention if you experience severe pain, swelling, or inability to bear weight after an injury. Contact a healthcare provider if pain persists, worsens, or if you notice deformity, numbness, or signs of infection (e.g., redness, warmth, or drainage) at the fracture site.

Tips for Medical Coders

Document the encounter as a subsequent visit for fracture care with nonunion. Ensure clinical notes specify the left foot, second metatarsal, displacement, and confirmation of nonunion (e.g., imaging or provider assessment). Code S92.322K is appropriate when the fracture has not healed and the patient is receiving ongoing treatment for this complication.