Ok when a patient is seen in the ER for a fracture we have to ascertain if the treatment applied was to treat the fracture or was it to afford comfort to the patient and to reduce the swelling until an ortho could see the patient and perform definitive fracture care. Unless it is a simple nondisplaced fracture this is usually the case, in which case the ortho still sees an acute fracture as the fracture has not yet been treated. However after fracture treatment then it can no longer be a fracture from the definition of an acute fracture which is an acute injury that has not been treated. After treatment, if the xray states that the fracture is malaligned or there is no no bone healing as of yet then you should query the provider as to whether this is a nonhealing fracture, because at this point the choice of acute fracture is off the table, it is healed, healing, non-healed, or malaligned, all of these have unique diagnosis codes without giving the patient the status of incurring a new fracture.