11/12/2023 0 Comments Icd 10 code for right humerus fracture![]() AP in external rotation best demonstrates greater tuberosity fractures.AP, scapular lateral and axillary views.Proximal Humerus Fx Xray / Diagnostic Tests Assess for head injury, LOC, cardiac/neurologic reasons for fall.Document NV exam, especially axillary nerve.Swelling and ecchymosis in shoulder which can expend into chest wall and down arm.Generally complain of shoulder pain after a fall.Lesser tuberosity fractures are pulled medially. If greater tuberosity is fractured it is pulled superiorly and posteriorly by the supraspinatus and infraspinatus. Supraspinatus abducts the head fragment in two part fractures. Deforming forces: Pectoralis major pulls the shaft medially, anteriorly and internally rotates.Most common site of injury to the axillary artery is in the third part(named in relation to the pec minor) of the artery at the origin of the anterior and posterior humeral circumflex arteries.If both indicate ischmia the positive predictive value of ischemia for an anatomic neck fx is 97%. Humeral head vascularity after fracture can be estimated by the amount of metaphyseal head extension, 2mm is associated with ischemia.Primary blood supply to humeral head is the ascending (arcuate) branch of anterior humeral circumflex artery which runs in the bicipital groove.(Jaberg, JBJS 74A:508 1992) Less significant supplies include the posterior humeral circumflex artery and small vessels enteriing through the rotator cuff insertions. ![]() Displaced greater tuberosity fx is pathognomonic of a longitudinal tear in the rotator cuff at the rotator interval between the supraspinatus and subscapularis tendons.Lesser tuberosity = insertion of subscapularis tendon.Greater tuberosity = insertion of supraspinatus, infraspinatus, and teres minor tendons.The humeral head is retroveted an average of 30 degrees. The neck-shaft inclination angle averages 145 degrees. Normal distance from the greater tuberosity to the superior protion of the articular surface of the humeral head = 7-8mm (Iannotti JP, JBJS 1992 74A:491), (Takase K, JSES 2002 11:557). Mean distance between the pectoralis major tendon and the top of the humeral articular surface is 5.6cm (Murachaovsky J, JSES 2006 15:675). Risk factors: osteoporosis, advance age.60 year old woman has on 8% risk of lifetime proximal humerus fracture (Lauritzen JB, Osteoporos Int 1993 3:127). 15-20% have significant displacement, angulation, malrotation or GT involvement.In young patients they generally involve high-energy trauma. In patients >60years the majority occur from a simple fall.Third most common fracture in patients >60 years of age.Majority occur in the elderly (fracture of senescence), are minimally displaced and stable.Proximal Humerus Fx Etiology / Epidemiology / Natural History 812._9(fracture of humerus, upper end, other head, upper epiphysis).812._3(fracture of humerus, upper end, greater tuberosity).812._2(fracture of humerus, upper end, anatomic neck).812._1(fracture of humerus, upper end, surgical neck).812._0(fracture of humerus, upper end, unspecified).P- subsequent encounter for fracture with malunion K- subsequent encounter for fracture with nonunion G- subsequent encounter for fracture with delayed healing See all Part proximal humerus fracture ICD-10 codes.ĭ- subsequent encounter for fracture with routine healing.S42.209A - Unspecified fracture of upper end of unspecified humerus, initial encounter for closed fracture.S42.202A - Unspecified fracture of upper end of left humerus, initial encounter for closed fracture.S42.201A - Unspecified fracture of upper end of right humerus, initial encounter for closed fracture.Associated Injuries / Differential Diagnosis
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