S92.351K Displaced fracture of fifth metatarsal bone, right foot, subsequent encounter for fracture with nonunion

Name of the Condition

• Technical Term: Displaced fracture of fifth metatarsal bone, right foot, subsequent encounter for fracture with nonunion
• Common Name: Broken fifth metatarsal (right foot, nonunion)

Summary

A displaced fracture of the fifth metatarsal bone in the right foot, with nonunion, refers to a break where the bone fragments remain out of alignment and have failed to heal properly after an initial injury. This subsequent encounter indicates ongoing management of the fracture, which has not united (fused) as expected. Nonunion may result from inadequate stabilization, poor blood supply, or other factors affecting healing.

Causes

Direct trauma to the foot, such as a fall or impact, is the primary cause of the initial fracture. Nonunion can develop due to insufficient immobilization, infection, poor nutrition, or underlying conditions that impair bone healing (e.g., diabetes, smoking).

Risk Factors

• Participation in high-impact sports or activities with foot trauma risk
• Wearing improper or non-supportive footwear
• Conditions that weaken bones (e.g., osteoporosis)
• Advanced age, which may reduce bone density and healing capacity
• Previous foot injuries or fractures
• Smoking or poor circulation

Symptoms

• Persistent pain and tenderness on the outer edge of the right foot
• Swelling or bruising that does not resolve over time
• Difficulty bearing weight on the right foot
• Possible deformity if the fracture remains displaced
• Sensation of instability in the foot

Diagnosis

A healthcare provider will perform a physical examination to assess pain, swelling, and range of motion. Imaging tests, such as X-rays or CT scans, are used to confirm nonunion by showing a persistent gap or lack of bone healing at the fracture site. Additional tests may evaluate blood flow or underlying conditions affecting healing.

Treatment Options

Treatment focuses on promoting bone union and may include surgical intervention (e.g., bone grafting, internal fixation) to stabilize the fracture. Non-surgical options like prolonged immobilization, bone stimulation, or physical therapy may be considered depending on the case. Pain management and addressing underlying risk factors (e.g., smoking cessation) are also part of the plan.

Prognosis and Follow-Up

Prognosis depends on the severity of the nonunion and response to treatment. Follow-up imaging is typically required to monitor healing progress. Long-term management may involve activity modifications or orthotic support to prevent recurrence.

Complications

• Chronic pain or instability in the foot
• Increased risk of re-fracture
• Infection (if surgical intervention is needed)
• Arthritis or joint damage due to misalignment
• Prolonged disability or reduced mobility

Lifestyle & Prevention

• Wear supportive footwear appropriate for activity
• Avoid high-impact activities that stress the foot
• Maintain a healthy diet rich in calcium and vitamin D to support bone health
• Address underlying conditions (e.g., diabetes) that may impair healing
• Gradually return to activity after injury, as advised by a healthcare provider

When to Seek Professional Help

Seek medical attention if pain persists, swelling worsens, or weight-bearing becomes increasingly difficult. Prompt evaluation is important if signs of infection (e.g., redness, fever) or new deformity appear.

Tips for Medical Coders

Document the encounter as a subsequent visit for fracture with nonunion. Include details about the fracture's status (e.g., displacement, lack of healing) and any interventions performed. Ensure documentation supports the nonunion diagnosis and aligns with the code's specificity.