S92.345A Nondisplaced fracture of fourth metatarsal bone, left foot, initial encounter for closed fracture

Name of the Condition

• Nondisplaced fracture of fourth metatarsal bone, left foot, initial encounter for closed fracture
• ICD-10 code: S92.345A

Summary

A nondisplaced fracture of the fourth metatarsal bone in the left foot is a break in the long bone of the forefoot where the bone fragments remain in their normal alignment. This injury typically results from trauma or repetitive stress and is classified as closed (no skin penetration) during the initial encounter. Management focuses on stabilizing the fracture and promoting healing.

Causes

Direct trauma to the foot, such as a fall, impact during sports, or a heavy object dropped on the foot, is a common cause. Stress fractures may also occur from overuse, particularly in activities involving repetitive weight-bearing or sudden increases in physical activity.

Risk Factors

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

Symptoms

• Pain localized to the outer midfoot area of the left foot
• Swelling and bruising around the affected bone
• Difficulty bearing weight or walking on the left foot
• Possible mild tenderness without visible deformity

Diagnosis

A healthcare provider will perform a physical examination to assess pain, swelling, and range of motion. Imaging tests, such as X-rays, are typically used to confirm the fracture and verify that it is nondisplaced. Additional imaging may be considered if clinical suspicion for a more complex injury exists.

Treatment Options

Treatment often includes rest, ice, compression, and elevation (RICE) to reduce swelling. Immobilization with a cast, boot, or stiff-soled shoe may be recommended to protect the fracture. Pain management with over-the-counter medications or prescribed analgesics may be used. Weight-bearing restrictions are common initially, with gradual return to activity as healing progresses.

Prognosis and Follow-Up

Most nondisplaced metatarsal fractures heal well with conservative management. Follow-up appointments are typically scheduled to monitor healing, often with repeat imaging to confirm bone union. Return to normal activities usually occurs within 6–8 weeks, depending on the individual’s healing rate and activity level.

Complications

While rare, potential complications include delayed union, nonunion, or progression to a displaced fracture if the injury is not properly managed. Infection is unlikely in closed fractures but may occur with open injuries. Chronic pain or arthritis in the affected area is possible but uncommon.

Lifestyle & Prevention

Wearing supportive, properly fitting footwear during activities can reduce stress on the metatarsals. Gradually increasing physical activity intensity and incorporating strength training for the feet and ankles may help prevent overuse injuries. Maintaining bone health through adequate nutrition (e.g., calcium, vitamin D) and avoiding high-impact activities on hard surfaces can also lower risk.

When to Seek Professional Help

Seek medical attention if pain is severe, worsens, or does not improve with rest. Immediate care is needed if there is obvious deformity, inability to bear weight, or signs of infection (e.g., redness, warmth, pus). Persistent swelling or bruising beyond a few days should also prompt evaluation.

Tips for Medical Coders

Document the fracture as nondisplaced, specify the left foot, and confirm the encounter is initial and the fracture is closed. Ensure clinical notes support the absence of displacement and the closed nature of the injury. Code S92.345A is specific to the fourth metatarsal, left foot, and requires clear documentation of the fracture type and encounter details.