S49.049
Salter-Harris Type IV physeal fracture of upper end of humerus, unspecified arm
Clinical Classification Guidelines
Medical Intelligence & Overview
A Salter-Harris Type IV physeal fracture occurs in the growth plate (physis) of a bone, specifically affecting the upper end of the humerus in this case. This type of injury is particularly significant in children and adolescents because it involves the growth plate, which is responsible for bone growth. An ICD-10 code of S49.049 describes an unspecified arm injury with this specific fracture type. Recognizing such injuries is vital for appropriate management and to prevent long-term complications like growth disturbances.
Causes & Symptoms
Clinical Causes: Falls onto an outstretched arm Sports injuries involving trauma to the shoulder Direct blow or trauma to the upper arm or shoulder Motor vehicle accidents causing shoulder impact Twisting injuries during physical activity
Key Symptoms: Severe pain in the shoulder or upper arm Swelling and tenderness around the shoulder joint Limited or restricted movement of the arm Visible deformity or abnormal positioning of the shoulder Possible bruising around the injured area
Diagnostic & Treatment
Diagnosis Path: Diagnosis typically involves a detailed clinical examination and imaging studies. The healthcare provider will assess for pain, swelling, deformity, and range of motion. X-rays are the primary tool used to confirm the presence of a Salter-Harris Type IV fracture, revealing a fracture crossing through the growth plate and extending into the metaphysis and epiphysis. In some cases, additional imaging such as MRI may be used for detailed assessment, especially if there is concern for associated soft tissue injuries or vascular damage.
Treatment Protocols: Immobilization with a cast or brace to keep the bone aligned Closed reduction procedures to realign the fracture without surgery Surgical intervention (open reduction and internal fixation) if the fracture is severely displaced or unstable Monitoring through follow-up X-rays to ensure proper healing Pain management with appropriate medications Physical therapy later in recovery to regain shoulder mobility and strength
Clinical Advice & FAQs
Billing Guidance
Is S49.049 a billable ICD-10 code?
Yes, S49.049 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report S49.049?
Clinical documentation must specify the nature of Salter-Harris Type IV physeal fracture of upper end of humerus, unspecified arm and any associated comorbidities for accurate reporting.
Cite this Clinical Reference