Orthopedic Coding Alert

Define fracture care with ease.

Fractures are defined as a disruption in the integrity of a living bone, bone marrow, periosteum, and adjacent soft tissues. Fractures occur when a bone cannot withstand outside forces, the integrity of the bone has been lost, and the bone structure fails. Fracture care usually involves the expertise of an orthopedic physician who monitors the fractures healing. The ultimate goal is to secure union and to restore normal function.

Fracture healing involves five phases:

" fracture and inflammatory phase

" granulation tissue formation

" callus formation

" lamellar bone deposition

" remodeling.

Become FamiliarWith Site Vocab

Orthopedic coders also need to understand the many eponyms and terms that pertain to specific fracture. They will help you to recognize a fractures location. They are:

" Bankart fracture -- This is usually seen with an anterior dislocation of the shoulder where a small piece of bone is detached from the anteroinferior rim of the glenoid bone.

" Bennett fracture -- The thumb is dislocated dorsally at the metacarpal. There is often an associated avulsion of the metacarpal on the volar surface of the metacarpal articular surface.

" Colles -- This refers to a fracture through the distal radius and often the ulnar styloid. It is known to produce a Silver Fork Deformity.

" de Quervain -- This involves a fracture of the scaphoid bone and a volar dislocation of the scaphoid fragment with the lunate bone.

" Dupuytren fracture -- a spiral fracture found at the distal end of the fibula.

" Lisfranc fracture -- a fracture of one or more of the bones at the site of the arched tarsometatarsal joint in the midfoot.

" Holstein-Lewis -- spiral fracture to the humeral shaft.

" Monteggia -- This fracture involves the proximal one-third of the ulna with dislocation (in any direction) of the radial head. This results in the ulna fracture fragments riding over one another.

" Pilon -- a fracture of the distal metaphysic of the tibia that extends into the ankle joint.

" Plafond -- a fracture that involved the surface of the distal tibia where it meets the Talus bone.

" Salter-Harris -- a fracture of the epiphyseal growth plate in children.

" Smith fracture -- This is the reverse of the Colles as the distal fragment of the radius is dislocated volarly.

" Supracondylar fracture --refers to a fracture of the humerus at the distal metaphysic.