![]() Thus, in an ankle fracture with an unstable syndesmosis, surgery is typically recommended. Because of a disrupted, unstable syndesmosis, the tibia and fibula are not held together properly, which makes for a very unstable ankle joint that is prone to chronic disability and arthritis – if not repaired. In some fractures, the ligament structures (called the syndesmosis) that hold together the two leg bones (the tibia and the fibula) that form the ankle socket are torn. Perhaps the most important “classification” of ankle fracture to both the doctor and the patient is whether the fracture will need surgical correction or not. Ankle fractures can be classified by the mechanism that caused that fracture, or the number of locations that have fractured, or by the location of the fracture of the fibula (the bone on the outside of the ankle) relative to the ankle joint line. There are many varieties of ankle fracture that can occur. Tips and Instructions from the Cast Room.Ankle Fracture with Unstable Syndesmosis.Patients with Sensation or Circulation Loss in the Feet.Midfoot Impingement Syndrome and Degenerative Joint Disease of the Midfoot.Excess Body Weight and Foot and Ankle Problems.For a subsequent admission, only code the injuries that meet the criteria in ACS 0001 Principal diagnosis or ACS 0002 Additional diagnoses. Please note that as per ACS 1907 Multiple injuries, in the initial admission all documented injuries must be coded. ![]() To code the unstable ankle injury, if there is no further specificity of the type of unstable ankle injury (eg sprain), assign S99.8 Other specified injuries of ankle and foot following the Index entry Injury (traumatic) (see also specified injury type)/ankle/specified NEC. Therefore, as there is no Index entry for Maisonneuve fracture, the documented components of the injury must be coded separately.įor the fibula fracture VICC advises to use radiology or review other parts of the clinical record to verify the specific site(s) of fibula fracture and then follow appropriate Index entries under lead term Fracture/fibula to assign the correct code. VICC research also confirms that ankle syndesmosis injury is a sprain of the ligaments in the ankle, therefore VICC advises to follow the Index entry Sprain, strain (joint) (ligament)/ankle to assign a code from S93.4- Sprain and strain of ankle.įurther research by VICC confirms that Maisonneuve fracture is defined as a spiral fracture of the proximal third of the fibula with unstable ankle injury and that the unstable ankle injury may involve fracture of the distal fibula. We also researched a Maisonneuve fracture and it refers to a combination of a fracture of the proximal fibula together with an unstable ankle injury (widening of the ankle mortise on x-ray), often comprising ligamentous injury (distal tibiofibular syndesmosis, deltoid ligament) and/or fracture of the medial malleolus.Ĭan the committee please what codes should be assigned for: Our research indicates that an ankle syndesmosis injury is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg. We have also had a patient with the diagnosis of Maisonneuve fracture and he underwent an ORIF of ankle syndesmosis. Some of the patients were treated conservatively and some of the others required surgical fixation to treat the injury. This year we have seen an increasing number of footballers admitted to our hospital with a diagnosis of ankle syndesmosis injury.
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