ICD 10. CLASS XIX. INJURIES, POISONING AND SOME OTHER CONSEQUENCES OF EXTERNAL CAUSES (S00-S99)
Excluded: birth injury (P10-P15)
obstetric trauma ( O70-O71)
This class contains the following blocks:
S00-S09 Head injuries
S10
-S19
Neck injuries
S20-S29 Chest injuries
S30-S39 Injuries to the abdomen, lower back, lumbar spine and pelvis
S40-S49 Shoulder and shoulder injuries
S50-S59 Elbow and forearm injuries
S60-S69 Wrist and hand injuries
S70-S79 Injury area hip joint and hips
S80-S89 Knee and leg injuries
S90-S99 Injuries to the ankle and foot area
In this class, the section labeled S is used for coding various types injuries related to a specific area of the body, and the section with the letter T is for coding multiple injuries and injuries to individual unspecified parts of the body, as well as poisoning and some other consequences of external causes.
In cases where the heading indicates the multiple nature of the injury, the conjunction “c” means simultaneous damage to both named areas of the body, and the conjunction “and” means both one and both areas. The principle of multiple coding of injuries should be applied as widely as possible. Combined categories for multiple injuries are given for use when the nature of each individual injury is insufficiently detailed or in primary statistical developments when
it is more convenient to register a single code; in other cases, each component of the injury should be coded separately. In addition, the morbidity and mortality coding rules outlined in T2 must be considered. Section S blocks, as well as headings T00-T14 And T90-T98 include injuries that, at the three-digit rubric level, are classified by type as follows:
Superficial trauma, including:
abrasion
water bubble (non-thermal)
contusion, including bruising, bruising and hematoma
trauma from a superficial foreign body (splinter) without major
open wound
insect bite (non-venomous)
Open wound, including:
bitten
sliced
torn
chopped:
NOS
with (penetrating) foreign body
Fracture, including:
closed:
splintered)
depressed)
speaker)
split)
incomplete)
impacted) with or without delayed healing
linear)
marching)
simple )
with offset)
pineal gland)
helical
with dislocation
with offset
Fracture:
open:
difficult )
infected)
gunshot) with or without delayed healing
with a puncture wound)
with a foreign body)
Excluded: fracture:
pathological ( M84.4)
with osteoporosis ( M80. -)
stressful ( M84.3)
incorrectly fused ( M84.0)
nonunion [false joint] ( M84.1)
Dislocations, sprains and overstrain of the capsular-ligamentous apparatus
joint, including:
separation)
gap)
stretch)
overvoltage)
traumatic: ) joint (capsule) ligament
hemarthrosis)
tear)
subluxation)
gap)
Nerve injury and spinal cord, including:
complete or incomplete spinal cord injury
disruption of the integrity of nerves and spinal cord
traumatic:
nerve transection
hematomyelia
paralysis (transient)
paraplegia
quadriplegia
Damage to blood vessels, including:
separation)
dissection)
tear)
traumatic: ) blood vessels
aneurysm or fistula (arteriovenous)
arterial hematoma)
gap)
Damage to muscles and tendons, including:
separation)
dissection)
tear) muscles and tendons
traumatic rupture)
Crushing [crushing]
Traumatic amputation
Internal organ injury, including:
from a blast wave)
bruise)
concussion injuries)
crushing)
dissection)
traumatic (s): ) internal organs
hematoma)
puncture)
gap)
tear)
Other and unspecified injuries
HEAD INJURIES (S00-S09)
Included: injuries:
ear
eyes
face (any part)
gums
jaws
temporomandibular joint area
oral cavity
sky
periocular area
scalp
language
tooth
Excluded: T20-T32)
consequences of foreign bodies entering:
ear ( T16)
larynx ( T17.3)
mouth ( T18.0)
nose ( T17.0-T17.1)
throat ( T17.2)
outer parts of the eye ( T15. -)
frostbite ( T33-T35)
bite and sting of a poisonous insect ( T63.4)
S00 Superficial head injury
Excluded: cerebral contusion (diffuse) ( S06.2)
focal ( S06.3)
injury to the eye and orbit ( S05. -)
S00.0 Superficial injury to the scalp
S00.1 Bruise of the eyelid and periorbital area. Bruise in the eye area
Excluded: bruise of the eyeball and orbital tissue ( S05.1)
S00.2 Other superficial injuries of the eyelid and periorbital region
Excludes: superficial injury to the conjunctiva and cornea ( S05.0)
S00.3 Superficial trauma to the nose
S00.4 Superficial ear injury
S00.5 Superficial trauma to the lip and oral cavity
S00.7 Multiple superficial head injuries
S00.8 Superficial trauma to other parts of the head
S00.9 Superficial head injury of unspecified location
S01 Open head wound
Excluded: decapitation ( S18)
injury to the eye and orbit ( S05. -)
traumatic amputation of part of the head ( S08. -)
S01.0 Open wound of the scalp
Excluded: scalp avulsion ( S08.0)
S01.1 Open wound of the eyelid and periorbital region
Open wound of the eyelid and periorbital region with or without involvement of the lacrimal ducts
S01.2 Open wound of the nose
S01.3 Open ear wound
S01.4 Open wound of the cheek and temporomandibular region
S01.5 Open wound of the lip and oral cavity
Excluded: tooth luxation ( S03.2)
tooth fracture ( S02.5)
S01.7 Multiple open head wounds
S01.8 Open wound to other areas of the head
S01.9 Open head wound of unspecified location
S02 Fracture of the skull and facial bones
Note During the initial statistical analysis of fractures of the skull and facial bones combined with intracranial trauma, one should be guided by the rules and instructions for coding morbidity
and mortality set out in part 2. The following subcategories (fifth character) are provided for optional use when additionally characterizing a condition when it is impossible or impractical to carry out multiple coding to identify a fracture or open wound; If the fracture is not characterized as open or closed, it should be
classify as closed:
0 - closed
1 - open
S02.0 Fracture of the cranial vault. Frontal bone. Parietal bone
S02.1 Fracture of the base of the skull
Pits:
front
average
rear
Occipital bone. The upper wall of the orbit. Sinuses:
ethmoid bone
frontal bone
Sphenoid bone
Temporal bone
Excludes: eye sockets NOS ( S02.8)
floor of the orbit ( S02.3)
S02.2 Fracture of the nasal bones
S02.3 Orbital floor fracture
Excludes: eye sockets NOS ( S02.8)
superior wall of the orbit ( S02.1)
S02.4 Fracture of the zygomatic bone and upper jaw. Upper jaw (bone). Zygomatic arch
S02.5 Tooth fracture. Broken tooth
S02.6 Fracture lower jaw. Lower jaw (bones)
S02.7 Multiple fractures of the skull and facial bones
S02.8 Fractures of other facial bones and skull bones. Alveolar process. Eye sockets NOS. Palatine bone
Excluded: eye sockets:
bottom ( S02.3)
upper wall ( S02.1)
S02.9 Fracture of unspecified part of skull and facial bones
S03 Dislocation, sprain and strain of joints and ligaments of the head
S03.0 Dislocation of the jaw. Jaw (cartilage) (meniscus). Lower jaw. Temporomandibular joint
S03.1 Dislocation of the cartilaginous nasal septum
S03.2 Tooth luxation
S03.3 Dislocation of other and unspecified areas of the head
S03.4 Sprain and strain of the joint (ligaments) of the jaw. Temporomandibular joint (ligament)
S03.5 Sprain and strain of joints and ligaments of other and unspecified parts of the head
S04 Cranial nerve injury
S04.0 Injury optic nerve and visual pathways
Visual crossroads. 2nd cranial nerve. Visual cortex
S04.1 Oculomotor nerve injury. 3rd cranial nerve
S04.2 Trochlear nerve injury. 4th cranial nerve
S04.3 Injury trigeminal nerve. 5th cranial nerve
S04.4 Abducens nerve injury. 6th cranial nerve
S04.5 Injury facial nerve. 7th cranial nerve
S04.6 Injury auditory nerve. 8th cranial nerve
S04.7 Accessory nerve injury. 11th cranial nerve
S04.8 Injury to other cranial nerves
Glossopharyngeal nerve
Hypoglossal nerve
Olfactory nerve
Vagus nerve
S04.9 Unspecified cranial nerve injury
S05 Injury to the eye and orbit
Excluded: injury:
oculomotor nerve ( S04.1)
optic nerve ( S04.0)
open wound of the eyelid and periorbital region ( S01.1)
fracture of the orbital bones ( S02.1, S02.3, S02.8)
superficial eyelid injury ( S00.1-S00.2)
S05.0 Conjunctival trauma and corneal abrasion without mention foreign body
Excluded: foreign body in:
conjunctival sac ( T15.1)
cornea ( T15.0)
S05.1 Contusion of the eyeball and orbital tissue. Traumatic hyphema
Excluded: bruise in the eye area ( S00.1)
bruise of the eyelid and periocular area ( S00.1)
S05.2 Laceration of the eye with prolapse or loss of intraocular tissue
S05.3 Laceration of the eye without prolapse or loss of intraocular tissue. Laceration of the eye NOS
S05.4 Penetrating wound of the orbit with or without the presence of a foreign body
Excluded: unremoved (long ago entered the orbit) foreign body due to a penetrating injury to the orbit ( H05.5)
S05.5 Penetrating wound of the eyeball with a foreign body
Excluded: unremoved (long ago entered the eyeball) foreign body ( H44.6-H44.7)
S05.6 Penetrating wound of the eyeball without a foreign body. Penetrating wound of the eye NOS
S05.7 Detachment of the eyeball. Traumatic enucleation
S05.8 Other injuries of the eye and orbit. Tear duct injury
S05.9 Injury to unspecified part of the eye and orbit. Eye injury NOS
S06 Intracranial injury
Note During the initial statistical analysis of intracranial injuries combined with fractures, one should
follow the rules and instructions for coding morbidity and mortality set out in part 2.
The following subcategories (fifth character) are provided for optional use in additional characterization of the condition when it is impossible or impractical to carry out multiple coding to identify intracranial injury and open wound:
0 - no open intracranial wound
1 - with an open intracranial wound
S06.0 Brain concussion. Commotio cerebri
S06.1 Traumatic cerebral edema
S06.2 Diffuse brain injury. Brain (contusion NOS, rupture NOS)
Traumatic compression of the brain NOS
S06.3 Focal brain injury
Focal:
cerebral
contusion
gap
traumatic intracerebral hemorrhage
S06.4 Epidural hemorrhage. Extradural hemorrhage (traumatic)
S06.5 Traumatic subdural hemorrhage
S06.6 Traumatic subarachnoid hemorrhage
S06.7 Intracranial injury with prolonged coma
S06.8 Other intracranial injuries
Traumatic hemorrhage:
cerebellar
intracranial NOS
S06.9 Unspecified intracranial injury. Brain injury NOS
Excludes: head injury NOS ( S09.9)
S07 Head crush
S07.0 Facial crush
S07.1 Skull crush
S07.8 Crushing of other parts of the head
S07.9 Crushing of an unspecified part of the head
S08 Traumatic amputation of part of the head
S08.0 Scalp avulsion
S08.1 Traumatic ear amputation
S08.8 Traumatic amputation of other parts of the head
S08.9 Traumatic amputation of unspecified part of head
Excluded: decapitation ( S18)
S09 Other and unspecified head injuries
S09.0 Injury to the blood vessels of the head, not elsewhere classified
Excluded: injury:
cerebral blood vessels ( S06. -)
precerebral blood vessels ( S15. -)
S09.1 Injury to the muscles and tendons of the head
S09.2 Traumatic rupture of the eardrum
S09.7 Multiple head injuries.
S00-S09.2
S09.8 Other specified head injuries
S09.9 Head injury, unspecified
Injury:
faces NOS
ear NOS
nose NOS
NECK INJURIES (S10-S19)
Included: injuries:
back of the neck
supraclavicular region
throat
T20-T32)
larynx ( T17.3)
esophagus ( T18.1)
throat ( T17.2)
trachea ( T17.4)
spine fracture NOS ( T08)
frostbite ( T33-T35)
injury:
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
T63.4)
S10 Superficial neck injury
S10.0 Throat bruise. Cervical esophagus. Larynx. Throats. Trachea
S10.1 Other and unspecified superficial injuries of the throat
S10.7 Multiple superficial neck injuries
S10.8 Superficial injury to other parts of the neck
S10.9 Superficial injury to an unspecified part of the neck
S11 Open neck wound
Excluded: decapitation ( S18)
S11.0 Open wound involving the larynx and trachea
Open tracheal wound:
NOS
cervical spine
Excludes: thoracic trachea ( S27.5)
S11.1 Open wound involving the thyroid gland
S11.2 Open wound involving the pharynx and cervical esophagus
Excludes: esophagus NOS ( S27.8)
S11.7 Multiple open wounds of the neck
S11.8 Open wound to other parts of the neck
S11.9 Open wound of unspecified part of neck
S12 Cervical spine fracture
Included: cervical:
vertebral arches
spine
spinous process
transverse process
vertebra
0 - closed
1 - open
S12.0 Fracture of the first cervical vertebra. Atlas
S12.1 Fracture of the second cervical vertebra. Axis
S12.2 Fracture of other specified cervical vertebrae
Excluded: multiple fractures of the cervical vertebrae ( S12.7)
S12.7 Multiple fractures of the cervical vertebrae
S12.8 Fracture of other parts of the neck. Hyoid bone. Larynx. Thyroid cartilage. Trachea
S12.9 Neck fracture of unspecified location
Cervical fracture:
vertebra NOS
spine NOS
S13 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus at the neck level
Excluded: ruptures or displacement (non-traumatic) of the intervertebral disc in the cervical region ( M50. -)
S13.0 Traumatic rupture of the intervertebral disc at the neck level
S13.1 Dislocation of the cervical vertebra. Cervical spine NOS
S13.2 Dislocation of another and unspecified part of the neck
S13.3 Multiple dislocations at the neck level
S13.4 Stretching and overstrain of the ligamentous apparatus of the cervical spine
Anterior longitudinal ligament of the cervical spine. Atlantoaxial joint. Atlantooccipital joint
Whiplash injury
S13.5 Stretching and overstrain of the ligamentous apparatus in the thyroid gland
Cricoarytenoid (joint) (ligament). Cricothyroid (joint) (ligament). Thyroid cartilage
S13.6 Sprain and strain of joints and ligaments of other and unspecified parts of the neck
S14 Nerve and spinal cord injury at neck level
S14.0 Contusion and swelling of the cervical spinal cord
S14.1 Other and unspecified injuries of the cervical spinal cord. Cervical spinal cord injury NOS
S14.2 Nerve root injury of the cervical spine
S14.3 Injury brachial plexus
S14.4 Peripheral nerve injury of the neck
S14.5 Cervical sympathetic nerve injury
S14.6 Injury to other and unspecified nerves of the neck
S15 Injury to blood vessels at the neck level
S15.0 Carotid artery injury. Carotid artery(general) (external) (internal)
S15.1 Vertebral artery injury
S15.2 External jugular vein injury
S15.3 Internal jugular vein injury
S15.7 Injury to several blood vessels at the neck level
S15.8 Injury to other blood vessels at the neck level
S15.9 Unspecified injury blood vessel at neck level
S16 Injury to muscles and tendons at the neck level
S17 Neck crush
S17.0 Crushing of the larynx and trachea
S17.8 Crushing of other parts of the neck
S17.9 Crush of unspecified part of neck
S18 Traumatic amputation at the neck level. Decapitation
S19 Other and unspecified neck injuries
S19.7 Multiple neck injuries. Injuries classified in more than one category S10-S18
S19.8 Other specified neck injuries
S19.9 Neck injury, unspecified
CHEST INJURIES (S20-S29)
Included: injuries:
mammary gland
chest (walls)
interscapular region
Excluded: thermal and chemical burns (T20-T32)
consequences of penetration of foreign bodies into:
bronchi ( T17.5)
lungs ( T17.8)
esophagus ( T18.1)
trachea ( T17.4)
spine fracture NOS ( T08)
frostbite ( T33-T35)
injuries:
armpit)
collarbone)
scapular region) ( S40-S49)
shoulder joint)
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
bite or sting of a poisonous insect ( T63.4)
S20 Superficial chest injury
S20.0 Breast contusion
S20.1 Other and unspecified superficial breast injuries
S20.2 Chest contusion
S20.3 Other superficial injuries of the anterior chest wall
S20.4 Other superficial injuries back wall chest
S20.7 Multiple superficial chest injuries
S20.8 Superficial injuries to another and unspecified part of the chest. Chest wall NOS
S21 Open chest wound
Excluded: traumatic:
hemopneumothorax ( S27.2)
hemothorax ( S27.1)
pneumothorax ( S27.0)
S21.0 Open breast wound
S21.1 Open wound of the anterior chest wall
S21.2 Open wound of the posterior chest wall
S21.7 Multiple open wounds of the chest wall
S21.8 Open wound of other parts of the chest
S21.9 Open wound of unspecified chest. Chest wall NOS
S22 Fracture of rib(s), sternum and thoracic spine
Included: thoracic:
vertebral arches
spinous process
transverse process
vertebra
The following subcategories (fifth character) are provided for optional use when additionally characterizing a condition when it is impossible or impractical to carry out multiple coding to identify a fracture or open wound; If a fracture is not classified as open or closed, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture:
collarbone ( S42.0
)
shoulder blades ( S42.1
)
S22.0 Fracture of the thoracic vertebra. Fracture of the thoracic spine NOS
S22.1 Multiple fractures of the thoracic spine
S22.2 Sternum fracture
S22.3 Rib fracture
S22.4 Multiple rib fractures
S22.5 Sunken chest
S22.8 Fracture of other parts of the thoracic bone
S22.9 Fracture of unspecified part of the bony chest
S23 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the chest
Excluded: dislocation, sprain and strain of the sternoclavicular joint ( S43.2
, S43.6
)
rupture or displacement (non-traumatic) of the intervertebral disc in the thoracic region ( M51. -)
S23.0 Traumatic rupture of the intervertebral disc in the thoracic region
S23.1 Dislocation of the thoracic vertebra. Thoracic spine NOS
S23.2 Dislocation of another and unspecified part of the chest
S23.3 Sprain and overstrain of the ligamentous apparatus of the thoracic spine
S23.4 Stretching and overstrain of the ligamentous apparatus of the ribs and sternum
S23.5 Stretching and overstrain of the ligamentous apparatus of another and unspecified part of the chest
S24 Injury to nerves and spinal cord in the thoracic region
S14.3)
S24.0 Contusion and swelling of the thoracic spinal cord
S24.1 Other and unspecified thoracic spinal cord injuries
S24.2 Nerve root injury of the thoracic spine
S24.3 Peripheral nerve injury of the chest
S24.4 Trauma to the sympathetic nerves of the thoracic region. Cardiac plexus. Esophageal plexus. Pulmonary plexus. Star node. Thoracic sympathetic node
S24.5 Injury to other thoracic nerves
S24.6 Specified thoracic nerve injury
S25 Trauma to blood vessels of the thoracic region
S25.0 Trauma to the thoracic aorta. Aorta NOS
S25.1 Innominate or subclavian artery injury
S25.2 Injury of the superior vena cava. Vena cava NOS
S25.3 Innominate or subclavian vein injury
S25.4 Trauma to pulmonary blood vessels
S25.5 Trauma to intercostal blood vessels
S25.7 Injury to several blood vessels in the thoracic region
S25.8 Injury to other blood vessels of the thoracic region. Azygos vein. Arteries or veins of the breast
S25.9 Injury to unspecified thoracic blood vessel
S26 Heart injury
Included: bruise)
gap)
puncture) of the heart
traumatic perforation)
The following subcategories (fifth character) are provided for optional use when additionally characterizing a condition when it is impossible or impractical to carry out multiple coding to identify a fracture or open wound; If a fracture is not classified as open or closed, it should be classified as closed:
S26.0 Heart injury with hemorrhage into the cardiac sac [hemopericardium]
S26.8 Other heart injuries
S26.9 Heart injury, unspecified
S27 Injury to other and unspecified organs of the thoracic cavity
The following subcategories (fifth character) are provided for optional use when additionally characterizing a condition when it is impossible or impractical to carry out multiple coding to identify a fracture or open wound; If a fracture is not classified as open or closed, it should be classified as closed:
0 - no open wound in the chest cavity
1 - with an open wound in the chest cavity
Excluded: injury:
cervical esophagus ( S10-S19)
trachea (cervical spine) ( S10-S19)
S27.0 Traumatic pneumothorax
S27.1 Traumatic hemothorax
S27.2 Traumatic hemopneumothorax
S27.3 Other lung injuries
S27.4 Bronchial injury
S27.5 Injury to the thoracic trachea
S27.6 Pleural trauma
S27.7 Multiple organ injuries chest cavity
S27.8 Trauma to other specified organs of the thoracic cavity. Diaphragms. Lymphatic thoracic duct
Esophagus (thoracic region). Thymus gland
S27.9 Injury to an unspecified thoracic organ
S28 Crushing of the chest and traumatic amputation of part of the chest
S28.0 Crushed chest
Excluded: loose chest ( S22.5)
S28.1 Traumatic amputation of part of the chest
Excluded: cutting of the torso at the chest level ( T05.8)
S29 Other and unspecified chest injuries
S29.0 Muscle and tendon injury at chest level
S29.7 Multiple chest injuries. Injuries classified in more than one category S20-S29.0
S29.8 Other specified chest injuries
S29.9 Chest injury, unspecified
INJURIES OF THE ABDOMEN, LOW BACK, LUMBAR SPINE AND PELVIS (S30-S39)
Included: injuries:
abdominal wall
anus
gluteal region
external genitalia
lateral abdomen
groin area
Excluded: thermal and chemical burns ( T20-T32)
consequences of foreign body penetration into:
anus and rectum ( T18.5)
genitourinary tract ( T19. -)
stomach, small and large intestines ( T18.2-T18.4)
spine fracture NOS ( T08)
frostbite ( T33-T35)
injuries:
back NOS ( T09. -)
spinal cord NOS ( T09.3)
torso NOS ( T09. -)
bite or sting of a poisonous insect ( T63.4)
S30 Superficial injury to the abdomen, lower back and pelvis
Excludes: superficial injury of the hip area ( S70. -)
S30.0 Contusion of the lower back and pelvis. Gluteal region
S30.1 Bruise of the abdominal wall. Side of the abdomen. Groin area
S30.2 Contusion of the external genitalia. Labia (major) (minor)
Penis. Crotch. Scrotums. Testicles. Vaginas. Vulvas
S30.7 Multiple superficial injuries to the abdomen, lower back and pelvis
S30.8 Other superficial injuries to the abdomen, lower back and pelvis
S30.9 Superficial injury of the abdomen, lower back and pelvis, unspecified location
S31 Open wound of the abdomen, lower back and pelvis
Excluded: open wound of the hip joint ( S71.0)
traumatic amputation of part of the abdomen, lower back and pelvis ( S38.2-S38.3)
S31.0 Open wound of the lower back and pelvis. Gluteal region
S31.1 Open wound of the abdominal wall. Side of the abdomen. Groin area
S31.2 Open wound of the penis
S31.3 Open wound of the scrotum and testicles
S31.4 Open wound of the vagina and vulva
S31.5 Open wound of other and unspecified external genitalia
Excludes: traumatic amputation of the external genitalia ( S38.2)
S31.7 Multiple open wounds of the abdomen, lower back and pelvis
S31.8 Open wound to another and unspecified part of the abdomen
S32 Fracture of the lumbosacral spine and pelvic bones
Includes: fracture at the lumbosacral level:
vertebral arches
spinous process
transverse process
vertebra
The following subcategories (fifth character) are provided for optional use when additionally characterizing a condition when it is impossible or impractical to carry out multiple coding to identify a fracture or open wound; If a fracture is not classified as open or closed, it should be classified as closed:
0 - closed
1 - open
Excludes: fracture of the hip joint NOS ( S72.0)
S32.0 Fracture of the lumbar vertebra. Lumbar spine fracture
S32.1 Sacral fracture
S32.2 Coccyx fracture
S32.3 Fracture of the ilium
S32.4 Acetabular fracture
S32.5 Pubic bone fracture
S32.7 Multiple fractures of the lumbosacral spine and pelvic bones
S32.8 Fractures of other and unspecified parts of the lumbosacral spine and pelvic bones
Fracture:
ischium
lumbosacral spine NOS
pelvis NOS
S33 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the lumbar spine and pelvis
Excluded: dislocation, sprain and strain of the hip joint and ligaments ( S73. -)
obstetric trauma of the joints and ligaments of the pelvis ( O71.6)
ruptures or displacement (non-traumatic) of the intervertebral disc in lumbar region (M51. -)
S33.0 Traumatic rupture of the intervertebral disc in the lumbosacral region
S33.1 Dislocation of the lumbar vertebra. Dislocation of the lumbar spine NOS
S33.2 Dislocation of the sacroiliac joint and sacrococcygeal joint
S33.3 Dislocation of another and unspecified part of the lumbosacral spine and pelvis
S33.4 Traumatic rupture of the pubic symphysis [symphysis pubis]
S33.5 Stretching and overstrain of the capsular-ligamentous apparatus of the lumbar spine
S33.6 Stretching and overstrain of the capsular-ligamentous apparatus of the sacroiliac joint
S33.7 Stretching and overstrain of the capsular-ligamentous apparatus of another and unspecified part of the lumbosacral spine and pelvis
S34 Injury to nerves and lumbar spinal cord at the level of the abdomen, lower back and pelvis
S34.0 Concussion and swelling of the lumbar spinal cord
S34.1 Other lumbar spinal cord injury
S34.2 Nerve root injury of the lumbosacral spine
S34.3 Cauda equina injury
S34.4 Injury to the lumbosacral nerve plexus
S34.5 Injury to the lumbar, sacral and pelvic sympathetic nerves
Celiac node or plexus. Hypogastric plexus. Mesenteric plexus (inferior) (superior). Visceral nerve
S34.6 Injury to peripheral nerve(s) of the abdomen, lower back and pelvis
S34.8 Injury to other and unspecified nerves in the abdomen, lower back and pelvis
S35 Injury to blood vessels in the abdomen, lower back and pelvis
S35.0 Trauma to the abdominal aorta
Excludes: aortic injury NOS ( S25.0)
S35.1 Injury to the inferior vena cava. Hepatic vein
Excludes: vena cava injury NOS ( S25.2)
S35.2 Injury to the celiac or mesenteric artery. Gastric artery
Gastroduodenal artery. Hepatic artery. Mesenteric artery (inferior) (superior). Splenic artery
S35.3 Portal or splenic vein injury. Mesenteric vein (inferior) (superior)
S35.4 Injury to the blood vessels of the kidney. Renal artery or vein
S35.5 Trauma to the iliac blood vessels. Hypogastric artery or vein. Iliac artery or veins
Arteries or veins of the uterus
S35.7 Injury to multiple blood vessels in the abdomen, lower back, and pelvis
S35.8 Injury to other blood vessels in the abdomen, lower back and pelvis. Arteries or veins of the ovary
S35.9 Injury to an unspecified blood vessel in the abdomen, lower back, and pelvis
S36 Abdominal trauma
S36.0 Spleen injury
S36.1 Injury to the liver or gallbladder. Bile duct
S36.2 Pancreatic injury
S36.3
Stomach injury
S36.4 Small intestinal injury
S36.5 Colon trauma
S36.6 Rectal injury
S36.7 Trauma to multiple intra-abdominal organs
S36.8 Trauma to other intra-abdominal organs. Peritoneum. Retroperitoneal space
S36.9 Injury to unspecified intra-abdominal organ
S37 Trauma to the pelvic organs
The following subcategories are provided for optional use in additional characterization of a condition where multiple coding is impossible or impractical:
0 - no open wound in abdominal cavity
1 - with an open wound in the abdominal cavity
Excludes: trauma to the peritoneum and retroperitoneal space ( S36.8)
S37.0 Kidney injury
S37.1 Ureteral injury
S37.2 Bladder injury
S37.3 Trauma to the urethra
S37.4
Ovarian injury
S37.5 Fallopian tube injury
S37.6
Uterine trauma
S37.7 Multiple pelvic organ trauma
S37.8 Trauma to other pelvic organs. Adrenal gland. Prostate gland. Seminal vesicles
Vas deferens
S37.9 Injury to unspecified pelvic organ
S38 Crushing and traumatic amputation of part of the abdomen, lower back and pelvis
S38.0 Crushing of the external genitalia
S38.1 Crushing of other and unspecified parts of the abdomen, lower back and pelvis
S38.2 Traumatic amputation of the external genitalia
Labia (major) (minor). Penis. Scrotums. Testicles. Vulvas
S38.3 Traumatic amputation of another and unspecified part of the abdomen, lower back and pelvis
Excluded: cutting of the torso at the level of the abdomen ( T05.8)
S39 Other and unspecified injuries of the abdomen, lower back and pelvis
S39.0 Injury to the muscles and tendons of the abdomen, lower back and pelvis
S39.6 Combined injury of intra-abdominal (s) and pelvic organ(s)
S39.7 Other multiple injuries to the abdomen, lower back and pelvis
Injuries classified in more than one category S30-S39.6
Excluded: combination of injuries classified under
S36. — with injuries classified in the rubric S37
. — (S39.6
)
S39.8 Other specified injuries to the abdomen, lower back and pelvis
S39.9 Injury to the abdomen, lower back and pelvis, unspecified
INJURIES OF THE SHOULDER GIRLE AND SHOULDER (S40-S49)
Included: injuries:
armpit
scapular region
Excluded: bilateral injury to the shoulder girdle and shoulder ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
hands (unspecified location) ( T10-T11)
elbow ( S50
-S59
)
bite or sting of a poisonous insect ( T63.4)
S40 Superficial injury of the shoulder girdle and shoulder
S40.0 Bruise of the shoulder girdle and shoulder
S40.7 Multiple superficial injuries of the shoulder girdle and shoulder
S40.8 Other superficial injuries of the shoulder girdle and shoulder
S40.9 Superficial injury of the shoulder girdle and shoulder, unspecified
S41 Open wound of the shoulder girdle and shoulder
Excludes: traumatic amputation of the shoulder girdle and shoulder ( S48. -)
S41.0 Open wound of the shoulder girdle
S41.1 Open shoulder wound
S41.7 Multiple open wounds of the shoulder girdle and shoulder
S41.8 Open wound to another and unspecified part of the shoulder girdle
S42 Fracture at the level of the shoulder girdle and shoulder
0 - closed
1 - open
S42.0 Clavicle fracture
Clavicles:
acromial end
body
sternal end
S42.1 Fracture of the scapula. Acromial process. Acromion. Shoulder blades (body) (glenoid cavity) (neck)
Shoulder blade
S42.2 Upper end fracture humerus. Anatomical neck. Greater tubercle. Proximal end
Surgical neck. Upper epiphysis
S42.3 Fracture of the body [diaphysis] of the humerus. Humerus NOS. Shoulder NOS
S42.4 Fracture of the lower end of the humerus. Articular process. Distal end. External condyle
Internal condyle. Internal epicondyle. Lower epiphysis. Supracondylar region
Excluded: elbow fracture NOS ( S52.0)
S42.7 Multiple fractures of the clavicle, scapula and humerus
S42.8 Fracture of other parts of the shoulder girdle and shoulder
S42.9 Fracture of unspecified part of the shoulder girdle. Shoulder fracture NOS
S43 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the shoulder girdle
S43.0 Dislocation of the shoulder joint. Glenohumeral joint
S43.1 Dislocation of the acromioclavicular joint
S43.2 Dislocation of the sternoclavicular joint
S43.3 Dislocation of another and unspecified part of the shoulder girdle. Shoulder dislocation NOS
S43.4 Sprain and overstrain of the capsular-ligamentous apparatus of the shoulder joint
Coracobrachialis (ligaments). Rotator cuff (capsule)
S43.5 Stretching and overstrain of the capsular-ligamentous apparatus of the acromioclavicular joint
Acromioclavicular ligament
S43.6 Stretching and overstrain of the capsular-ligamentous apparatus of the sternoclavicular joint
S43.7 Stretching and overstrain of the capsular-ligamentous apparatus of another and unspecified part of the shoulder girdle
Sprain and overstrain of the capsular-ligamentous apparatus of the shoulder girdle NOS
S44 Nerve injury at the level of the shoulder girdle and shoulder
Excludes: brachial plexus injury ( S14.3)
S44.0 Ulnar nerve injury at shoulder level
Excludes: ulnar nerve NOS ( S54.0)
S44.1 Median nerve injury at shoulder level
Excludes: median nerve NOS ( S54.1)
S44.2 Radial nerve injury at shoulder level
Excludes: radial nerve NOS ( S54.2)
S44.3 Axillary nerve injury
S44.4 Musculocutaneous nerve injury
S44.5 Trauma to the cutaneous sensory nerve at the level of the shoulder girdle and shoulder
S44.7 Injury to multiple nerves at the level of the shoulder girdle and shoulder
S44.8 Injury to other nerves at the level of the shoulder girdle and shoulder
S44.9 Injury to unspecified nerve at the level of the shoulder girdle and shoulder
S45 Injury to blood vessels at the level of the shoulder girdle and shoulder
Excluded: subclavian injury:
arteries ( S25.1
)
veins ( S25.3
)
S45.0
Axillary artery injury
S45.1
Brachial artery injury
S45.2 Axillary or brachial vein injury
S45.3 Trauma to the superficial veins at the level of the shoulder girdle and shoulder
S45.7 Injury to several blood vessels at the level of the shoulder girdle and shoulder
S45.8 Injury to other blood vessels at the level of the shoulder girdle and shoulder
S45.9 Injury to an unspecified blood vessel at the level of the shoulder girdle and shoulder
S46 Injury to muscle and tendon at the level of the shoulder girdle and shoulder
Excluded: muscle and tendon injury at or below the elbow ( S56. -)
S46.0 Rotator cuff tendon injury
S46.1 Injury to the muscle and tendon of the long head of the biceps muscle
S46.2 Injury to the muscle and tendon of other parts of the biceps muscle
S46.3 Injury to the triceps muscle and tendon
S46.7 Injury to several muscles and tendons at the level of the shoulder girdle and shoulder
S46.8 Injury to other muscles and tendons at the level of the shoulder girdle and shoulder
S46.9 Injury to unspecified muscles and tendons at the level of the shoulder girdle and shoulder
S47 Crushing of the shoulder girdle and shoulder
Excluded: crushed elbow ( S57.0)
S48 Traumatic amputation of the shoulder girdle and shoulder
at elbow level ( S58.0)
upper limb at an unspecified level ( T11.6)
S48.0 Traumatic amputation at the level of the shoulder joint
S48.1 Traumatic amputation at the level between the shoulder and elbow joints
S48.9 Traumatic amputation of the shoulder girdle and shoulder at an unspecified level
S49 Other and unspecified injuries of the shoulder girdle and shoulder
S49.7 Multiple shoulder and shoulder injuries
Injuries classified in more than one category S40-S48
S49.8 Other specified injuries of the shoulder girdle and shoulder
S49.9 Injury to the shoulder girdle and shoulder, unspecified
ELBOW AND FOREARM INJURIES (S50-S59)
Excluded: bilateral elbow and forearm injury ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
hands at unspecified level ( T10-T11)
wrists and hands ( S60-S69)
bite or sting of a poisonous insect ( T63.4)
S50 Superficial forearm injury
Excludes: superficial injury of wrist and hand ( S60. -)
S50.0 Elbow bruise
S50.1 Contusion of another and unspecified part of the forearm
S50.7 Multiple superficial injuries of the forearm
S50.8 Other superficial forearm injuries
S50.9 Superficial injury of the forearm, unspecified. Superficial elbow injury NOS
S51 Open wound of the forearm
Excluded: open wound of wrist and hand ( S61. -)
traumatic amputation of the forearm ( S58. -)
S51.0 Open wound of the elbow
S51.7 Multiple open wounds of the forearm
S51.8 Open wound on other parts of the forearm
S51.9 Open wound of unspecified part of forearm
S52 Fracture of forearm bones
The following subcategories are provided for optional use to further characterize a condition where multiple coding for fracture and open wound is not possible or practical; If a fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture at the level of the wrist and hand ( S62. -)
S52.0 Upper end fracture ulna. Coronoid process. Elbow NOS. Fracture-dislocation of Monteggia
Olecranon process. Proximal end
S52.1 Fracture of the upper end of the radius. Heads. Shakey. Proximal end
S52.2 Fracture of the body [diaphysis] of the ulna
S52.3 Fracture of the body [diaphysis] of the radius
S52.4 Combined fracture of the diaphysis of the ulna and radius
S52.5 Fracture of the lower end of the radius. Collis fracture. Smith's fracture
S52.6 Combined fracture of the lower ends of the ulna and radius bones
S52.7 Multiple fractures of the forearm bones
Excluded: combined fracture of the ulna and radius:
lower ends ( S52.6)
diaphysis ( S52.4)
S52.8 Fracture of other parts of the bones of the forearm. The lower end of the ulna. Heads of the ulna
S52.9 Fracture of unspecified part of forearm bones
S53 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the elbow joint
S53.0 Dislocation of the radial head. Humeral joint
Excluded: Monteggia fracture-dislocation ( S52.0)
S53.1 Unspecified dislocation of the elbow joint. Shoulder elbow joint
Excluded: dislocation of the radial head only ( S53.0)
S53.2 Traumatic rupture of the radial collateral ligament
S53.3 Traumatic rupture of the ulnar collateral ligament
S53.4 Sprain and overstrain of the capsular-ligamentous apparatus of the elbow joint
S54 Nerve injury at forearm level
Excluded: nerve injury at the level of the wrist and hand ( S64. -)
S54.0 Trauma to the ulnar nerve at the level of the forearm. Ulnar nerve NOS
S54.1 Injury to the median nerve at the level of the forearm. Median nerve NOS
S54.2 Trauma to the radial nerve at the level of the forearm. Radial nerve NOS
S54.3 Trauma to the cutaneous sensory nerve at the level of the forearm
S54.7 Injury to multiple nerves at the forearm level
S54.8 Injury to other nerves at the level of the forearm
S54.9 Injury to an unspecified nerve at the level of the forearm
S55 Injury to blood vessels at the level of the forearm
Excluded: injury:
blood vessels at the level of the wrist and hand ( S65. -)
blood vessels at shoulder level ( S45.1-S45.2)
S55.0 Injury ulnar artery at the level of the forearm
S55.1 Trauma to the radial artery at the level of the forearm
S55.2 Injury to a vein at the level of the forearm
S55.7 Injury to several blood vessels at the level of the forearm
S55.8 Injury to other blood vessels at the level of the forearm
S55.9 Injury to an unspecified blood vessel at the level of the forearm
S56 Injury to muscle and tendon at forearm level
Excluded: muscle and tendon injury at or below the wrist ( S66. -)
S56.0 Flexor injury thumb and its tendons at the level of the forearm
S56.1 Injury to the flexor of the other finger(s) and its tendon at the level of the forearm
S56.2 Injury to another flexor and its tendon at the level of the forearm
S56.3 Injury to the extensor or abductor muscles of the thumb and their tendons at the level of the forearm
S56.4 Injury to the extensor of the other finger(s) and its tendon at the level of the forearm
S56.5 Injury to another extensor and tendon at the level of the forearm
S56.7 Injury to several muscles and tendons at the forearm level
S56.8 Injury to other and unspecified muscles and tendons at the level of the forearm
S57 Crush of the forearm
Excluded: crushed wrist and hand ( S67. -)
S57.0 Elbow crush injury
S57.8 Crushing of other parts of the forearm
S57.9 Crush of unspecified part of forearm
S58 Traumatic amputation of the forearm
S68. -)
S58.0 Traumatic amputation at the elbow joint
S58.1 Traumatic amputation at the level between the elbow and radial carpal joints
S58.9 Traumatic amputation of the forearm at an unspecified level
S59 Other and unspecified injuries of the forearm
Excludes: other and unspecified injuries of the wrist and hand ( S69. -)
S59.7 Multiple forearm injuries. Injuries classified in more than one category S50-S58
S59.8 Other specified forearm injuries
S59.9 Forearm injury, unspecified
WRIST AND HAND INJURIES (S60-S69)
Excluded: bilateral wrist and hand injuries ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
hand injuries at unspecified level ( T10-T11)
bite or sting of a poisonous insect ( T63.4)
S60 Superficial injury of wrist and hand
S60.0 Bruised finger(s) of the hand without damage to the nail plate. Bruised finger(s) of the hand NOS
Excluded: bruise involving the nail plate ( S60.1)
S60.1 Bruised finger(s) of the hand with damage to the nail plate
S60.2 Contusion of other parts of the wrist and hand
S60.7 Multiple superficial injuries of the wrist and hand
S60.8 Other superficial injuries of the wrist and hand
S60.9 Superficial injury of wrist and hand, unspecified
S61 Open wound of wrist and hand
Excludes: traumatic amputation of the wrist and hand ( S68. -)
S61.0 Open wound of the finger(s) of the hand without damage to the nail plate
Open wound of finger(s) NOS
Excluded: open wound involving the nail plate ( S61.1)
S61.1 Open wound of the finger(s) of the hand with damage to the nail plate
S61.7 Multiple open wounds of the wrist and hand
S61.8 Open wound to other parts of the wrist and hand
S61.9 Open wound of unspecified part of wrist and hand
S62 Fracture at the level of the wrist and hand
The following subcategories are provided for optional use to further characterize a condition where multiple coding to identify fracture and open wound is not possible or practical; If a fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture of the distal ends of the ulna and radius ( S52. -)
S62.0 Fracture of the scaphoid bone of the hand
S62.1 Fracture of other wrist bone(s). Capitate. Hook-shaped. Lunar. Pisiform
Trapezium [large polygonal]. Trapezoidal [small polygonal]. Triangular
S62.2 Fracture of the first metacarpal bone. Bennett's fracture
S62.3 Fracture of the other metacarpal bone
S62.4 Multiple metacarpal fractures
S62.5 Fracture of the thumb
S62.6 Fracture of another finger
S62.7 Multiple finger fractures
S62.8 Fracture of another and unspecified part of the wrist and hand
S63 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus at the level of the wrist and hand
S63.0 Sprained wrist. Wrists (bones). Carpometacarpal joint. Proximal end of the metacarpal bone
Midcarpal joint. Wrist joint. Distal radioulnar joint
Distal end of the radius. Distal end of the ulna
S63.1 Dislocated finger. Interphalangeal joint of the hand. Metacarpal bone distal end. Metacarpophalangeal joint
Phalanges of the hand. Thumb
S63.2 Multiple dislocations of fingers
S63.3 Traumatic rupture of the wrist and metacarpus ligament. Collateral ligament of the wrist
Radiocarpal ligament. Radiocarpal (palm) ligament
S63.4 Traumatic rupture of the finger ligament at the level of the metacarpophalangeal and interphalangeal joint(s)
Collateral. Palm. Palmar aponeurosis
S63.5 Stretching and overstrain of the capsular-ligamentous apparatus at the wrist level. Carpal (joint)
Wrist (joint) (ligament)
S63.6 Stretching and overstrain of the capsular-ligamentous apparatus at the level of the finger
Interphalangeal joint of the hand. Metacarpophalangeal joint. Phalanges of the hand. Thumb
S63.7 Stretching and overstrain of the capsular-ligamentous apparatus of another and unspecified part of the hand
S64 Nerve injury at wrist and hand level
S64.0 Ulnar nerve injury at the wrist and hand
S64.1 Median nerve injury at the wrist and hand
S64.2 Radial nerve injury at the wrist and hand
S64.3 Thumb nerve injury
S64.4 Nerve injury to another finger
S64.7 Injury to multiple nerves at the wrist and hand
S64.8 Injury to other nerves in the wrist and hand
S64.9 Injury to an unspecified nerve at the wrist and hand level
S65 Trauma to blood vessels at the level of the wrist and hand
S65.0 Trauma to the ulnar artery at the level of the wrist and hand
S65.1 Radial artery injury at the wrist and hand
S65.2 Superficial palmar arch injury
S65.3 Deep palmar arch injury
S65.4 Injury to the blood vessel(s) of the thumb
S65.5 Injury to the blood vessel(s) of another finger
S65.7 Injury to multiple blood vessels at the wrist and hand
S65.8 Injury to other blood vessels at the wrist and hand
S65.9 Injury to an unspecified blood vessel at the wrist and hand level
S66 Injury to muscle and tendon at wrist and hand level
S66.0 Injury of the flexor pollicis longus and its tendon at the level of the wrist and hand
S66.1 Injury to the flexor of the other finger and its tendon at the level of the wrist and hand
S66.2 Injury to the extensor pollicis and its tendon at the level of the wrist and hand
S66.3 Injury to the extensor muscle of the other finger and its tendon at the level of the wrist and hand
S66.4 Injury to the intrinsic muscle and tendon of the thumb at the level of the wrist and hand
S66.5 Injury to the intrinsic muscle and tendon of the other finger at the level of the wrist and hand
S66.6 Injury to multiple flexor muscles and tendons at the wrist and hand level
S66.7 Injury to multiple extensor muscles and tendons at the wrist and hand level
S66.8 Injury to other muscles and tendons at the wrist and hand level
S66.9 Injury to unspecified muscles and tendons at the wrist and hand level
S67 Crushed wrist and hand
S67.0 Crushing of the thumb and other finger(s) of the hand
S67.8 Crushing of another and unspecified part of the wrist and hand
S68 Traumatic amputation of wrist and hand
S68.0 Traumatic amputation of the thumb (complete) (partial)
S68.1 Traumatic amputation of one other finger of the hand (complete) (partial)
S68.2 Traumatic amputation of two or more fingers (complete) (partial)
S68.3 Combined traumatic amputation of (part of) the finger(s) and other parts of the wrist and hand
S68.4 Traumatic amputation of the hand at the wrist level
S68.8 Traumatic amputation of other parts of the wrist and hand
S68.9 Traumatic amputation of the wrist and hand at an unspecified level
S69 Other and unspecified injuries of wrist and hand
S69.7 Multiple injuries to the wrist and hand. Injuries classified in more than one category S60-S68
S69.8 Other specified injuries of the wrist and hand
S69.9 Wrist and hand injury, unspecified
INJURIES TO THE HIP AND THIGH AREA (S70-S79)
Excluded: bilateral injury to the hip and thigh ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
leg injuries at unspecified level ( T12-T13)
bite or sting of a poisonous insect ( T63.4)
S70 Superficial injury of the hip joint and thigh
S70.0 Bruise of the hip area
S70.1 Bruised thigh
S70.7 Multiple superficial injuries of the hip joint and thigh
S70.8 Other superficial injuries of the hip and thigh area
S70.9 Superficial injury of the hip joint and thigh, unspecified
S71 Open wound of the hip joint and thigh
Excludes: traumatic amputation of the hip joint and thigh ( S78. -)
S71.0 Open wound of the hip joint area
S71.1 Open thigh wound
S71.7 Multiple open wounds of the hip and thigh area
S71.8 Open wound of another and unspecified part of the pelvic girdle
S72 Fracture of the femur
The following subcategories are provided for optional use to further characterize a condition where multiple coding to identify fracture and open wound is not possible or practical; If a fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
S72.0 Femoral neck fracture. Fracture of the hip joint NOS
S72.1 Pertrochanteric fracture. Intertrochanteric fracture. Trochanteric fracture
S72.2 Subtrochanteric fracture
S72.3 Fracture of the body [diaphysis] of the femur
S72.4 Fracture of the lower end of the femur
S72.7 Multiple femur fractures
S72.8 Fractures of other parts of the femur
S72.9 Fracture of unspecified part of femur
S73 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the hip joint and pelvic girdle
S73.0 Hip dislocation
S73.1 Stretching and overstrain of the capsular-ligamentous apparatus of the hip joint
S74 Nerve injuries at the level of the hip joint of the thigh
S74.0 Injury to the sciatic nerve at the level of the hip joint and thigh
S74.1 Femoral nerve injury at the hip and thigh level
S74.2 Injury to the cutaneous sensory nerve at the level of the hip joint and thigh
S74.7 Injury to multiple nerves at the hip and thigh level
S74.8 Injury to other nerves at the hip and thigh level
S74.9 Injury to unspecified nerve at the level of the hip and thigh
S75 Trauma to blood vessels at the level of the hip joint and thigh
Excluded: injury popliteal artery (S85.0)
S75.0 Femoral artery injury
S75.1 Femoral vein injury
S75.2 Injury of the great saphenous vein at the level of the hip joint and thigh
Excludes: saphenous vein injury NOS ( S85.3)
S75.7 Injury to several blood vessels at the level of the hip joint and thigh
S75.8 Injury to other blood vessels at the hip and thigh level
S75.9 Injury to an unspecified blood vessel at the level of the pelvis, femoral joint, and thigh
S76 Injury to muscle and tendon at the level of the hip joint and thigh
S76.0 Injury to the muscle and tendon of the hip joint
S76.1 Injury to the quadriceps muscle and its tendon
S76.2 Injury to the adductor muscle and tendon
S76.3 Injury to the muscle and tendon of the posterior muscle group at the hip level
S76.4 Injury to other and unspecified muscles and tendons at the hip level
S76.7 Injury to several muscles and tendons at the hip and thigh level
S77 Crush of the hip joint and thigh
S77.0 Crush area of the hip joint
S77.1 Crush thigh
S77.2 Crushing of the hip and thigh area
S78 Traumatic amputation of the hip and thigh area
Excludes: traumatic amputation of the leg at an unspecified level ( T13.6)
S78.0 Traumatic amputation at the level of the hip joint
S78.1 Traumatic amputation at the level between the hip and knee joints
S78.9 Traumatic amputation of the hip and thigh area at an unspecified level
S79 Other and unspecified injuries of the hip and thigh area
S79.7 Multiple injuries to the hip and thigh area
Injuries classified in more than one category S70-S78
S79.8 Other specified injuries of the hip and thigh area
S79.9 Injury to the hip and thigh area, unspecified
KNEE AND SHIN INJURIES (S80-S89)
Included: ankle and ankle fracture
Excluded: bilateral knee and lower leg injuries ( T00-T07)
thermal and chemical burns ( T20-T32)
frostbite ( T33-T35)
injuries:
ankle and foot, excluding ankle and ankle fractures ( S90-S99)
legs at unspecified level ( T12-T13)
bite or sting of a poisonous insect ( T63.4)
S80 Superficial injury of the leg
Excludes: superficial injury of the ankle and foot ( S90. -)
S80.0 Injury knee joint
S80.1 Contusion of another and unspecified part of the leg
S80.7 Multiple superficial injuries of the leg
S80.8 Other superficial leg injuries
S80.9 Superficial injury of the lower leg, unspecified
S81 Open wound of the leg
Excluded: open wound of the ankle and foot area ( S91. -)
traumatic amputation of the lower leg ( S88. -)
S81.0 Open wound of the knee joint
S81.7 Multiple open wounds of the leg
S81.8 Open wound of other parts of the leg
S81.9 Open wound of the lower leg, unspecified location
S82 Fracture of the leg, including the ankle joint
Included: ankle fracture
The following subcategories are provided for optional use to further characterize a condition where multiple coding to identify fracture and open wound is not possible or practical; If a fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture of the foot, excluding the ankle joint ( S92. -)
S82.0 Patella fracture. Knee cup
S82.1 Proximal tibia fracture
Tibia:
condyles)
heads) with or without mention
proximal) mention of a fracture
tuberosity) of the fibula
S82.2 Fracture of the body [diaphysis] of the tibia
S82.3 Fracture distal section tibia
With or without mention of fibula fracture
Excludes: medial malleolus ( S82.5)
S82.4 Fibula fracture only
Excludes: external [lateral] malleolus ( S82.6)
S82.5 Fracture of the medial malleolus
Tibia involving:
ankle joint
ankles
S82.6 Fracture of the outer [lateral] malleolus
Fibula involving:
ankle joint
ankles
S82.7 Multiple fractures of the leg
Excluded: combined fractures of the tibia and fibula:
lower end ( S82.3)
body [diaphysis] ( S82.2
)
upper end ( S82.1)
S82.8 Fractures of other parts of the leg
Fracture:
ankle NOS
bimalleolar
trimalleolar
S82.9 Fracture of unspecified leg
S83 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the knee joint
Excluded: defeat:
internal ligaments of the knee joint ( M23. -)
patella ( M22.0-M22.3)
dislocation of the knee joint:
old ( M24.3)
pathological ( M24.3)
repetitive [habitual] ( M24.4)
S83.0 Patella dislocation
S83.1 Dislocation of the knee joint. Tibiofibular joint
S83.2 Fresh meniscus tear
Breaking the horn like a bucket handle:
NOS
external [lateral] meniscus
internal [medial] meniscus
Excluded: old bucket-handle rupture of the meniscal horn ( M23.2)
S83.3 Fresh rupture of the articular cartilage of the knee joint
S83.4 Sprain, tear and strain of the (external) (internal) collateral ligament
S83.5 Sprain, tear and strain of the (anterior) (posterior) cruciate ligament of the knee joint
S83.6 Sprain, rupture and overstrain of other and unspecified elements of the knee joint
Common patellar ligament. Interfibular syndesmosis and superior ligament
S83.7 Injury to multiple structures of the knee joint
Injury of (external) (internal) meniscus in combination with injury of (lateral) (cruciate) ligaments
S84 Nerve injury at calf level
Excluded: nerve injury at the level of the ankle and foot ( S94. -)
S84.0 Tibial nerve injury at the level of the leg
S84.1 Injury to the peroneal nerve at the level of the leg
S84.2 Injury to the cutaneous sensory nerve at the level of the leg
S84.7 Injury to multiple nerves at the calf level
S84.8 Injury to other nerves at the calf level
S84.9 Injury to unspecified nerve at calf level
S85 Injury to blood vessels at the level of the leg
Excludes: injury to blood vessels at the level of the ankle and foot ( S95. -)
S85.0 Popliteal artery injury
S85.1 Tibial (anterior) (posterior) artery injury
S85.2 Peroneal artery injury
S85.3 Injury of the great saphenous vein at the level of the leg. Great saphenous vein NOS
S85.4 Injury of the small saphenous vein at the level of the leg
S85.5 Popliteal vein injury
S85.7 Injury to several blood vessels at the calf level
S85.8 Injury to other blood vessels at the calf level
S85.9 Injury to unspecified blood vessel at calf level
S86 Injury to muscle and tendon at shin level
Excludes: muscle and tendon injury at the ankle and foot level ( S96. -)
S86.0 Heel [Achilles] tendon injury
S86.1 Injury to other muscle(s) and tendon(s) of the posterior muscle group at the level of the lower leg
S86.2 Injury to the muscle(s) and tendon(s) of the anterior muscle group at the calf level
S86.3 Injury to the muscle(s) and tendon(s) of the peroneal muscle group at the level of the lower leg
S86.7 Injury to several muscles and tendons at the calf level
S86.8 Injury to other muscles and tendons at the calf level
S86.9 Injury to unspecified muscles and tendons at the calf level
S87 Crushed leg
Excluded: crushing of the ankle and foot ( S97. -)
S87.0 Knee crush injury
S87.8 Crush of another and unspecified part of the leg
S88 Traumatic amputation of the lower leg
Excluded: traumatic amputation:
ankle and foot ( S98. -)
lower limb at an unspecified level ( T13.6)
S88.0 Traumatic amputation at the level of the knee joint
S88.1 Traumatic amputation between the knee and ankle joints
S88.9 Traumatic amputation of the leg at an unspecified level
S89 Other and unspecified injuries of the leg
Excludes: other and unspecified ankle and foot injuries ( S99. -)
S89.7 Multiple lower leg injuries. Injuries classified in more than one category S80-S88
S89.8 Other specified lower leg injuries
S89.9 Unspecified lower leg injury
INJURIES TO THE ANKLE AND FOOT AREA (S90-S99)
Excluded: bilateral injury to the ankle and foot area ( T00-T07)
thermal and chemical burns and corrosion ( T20-T32)
fracture of the ankle and ankle ( S82. -)
frostbite ( T33-T35)
injuries of the lower extremity at an unspecified level ( T12-T13)
bite or sting of a poisonous insect ( T63.4)
S90 Superficial injury to the ankle and foot area
S90.0 Bruised ankle
S90.1 Bruised toe(s) without damage to the nail plate. Bruised toe(s) NOS
S90.2 Bruised toe(s) with damage to the nail plate
S90.3 Contusion of another and unspecified part of the foot
S90.7 Multiple superficial injuries of the ankle and foot
S90.8 Other superficial ankle and foot injuries
S90.9 Superficial injury of the ankle and foot, unspecified
S91 Open wound of the ankle and foot area
Excluded: traumatic amputation at the ankle and foot level ( S98. -)
S91.0 Open wound of the ankle area
S91.1 An open wound of the toe(s) without damage to the nail plate. Open wound of toe(s) NOS
S91.2 Open wound of the toe(s) with damage to the nail plate
S91.3 An open wound on other parts of the foot. Open foot wound NOS
S91.7 Multiple open wounds of the ankle and foot
S92 Fracture of the foot, excluding ankle fracture
The following subcategories are provided for optional use to further characterize a condition where multiple coding to identify fracture and open wound is not possible or practical; If a fracture is not designated as closed or open, it should be classified as closed:
0 - closed
1 - open
Excluded: fracture:
ankle joint ( S82. -)
ankles ( S82. -)
S92.0 Heel bone fracture. Heel bone. Heels
S92.1 Fracture of the talus. Astragalus
S92.2 Fracture of other tarsal bones. Cuboid
Wedge-shaped (intermediate) (internal) (external). Navicular bone of the foot
S92.3 Metatarsus fracture
S92.4 Big toe fracture
S92.5 Fracture of the other toe
S92.7 Multiple foot fractures
S92.9 Unspecified foot fracture
S93 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the ankle and foot
S93.0 Dislocation of the ankle joint. Talus. Lower end of the fibula
The lower end of the tibia. In the subtalar joint
S93.1 Dislocation of toe(s). Interphalangeal joint(s) of the foot. Metatarsophalangeal joint(s)
S93.2 Ligament rupture at the ankle and foot level
S93.3 Dislocation of another and unspecified part of the foot. Navicular bone of the foot. Tarsus (joints) (joints)
Tarsometatarsal joint(s)
S93.4 Sprain and strain of the ankle ligaments. Calcaneofibular ligament
Deltoid ligament. Internal collateral ligament. Talofibular bone
Tibiofibular ligament (distal)
S86.0)
S93.5 Stretching and overstrain of the capsular-ligamentous apparatus of the joints of the toe(s)
Interphalangeal joint(s). Metatarsophalangeal joint(s)
S93.6 Stretching and overstrain of the capsular-ligamentous apparatus of other and unspecified joints of the foot
Tarsals (ligaments). Tarsometatarsal ligament
S94 Nerve injury at ankle and foot level
S94.0 External [lateral] plantar nerve injury
S94.1 Internal [medial] plantar nerve injury
S94.2 Trauma to the deep peroneal nerve at the ankle and foot level
Terminal lateral branch of the deep peroneal nerve
S94.3 Trauma to the cutaneous sensory nerve at the level of the ankle joint and foot
S94.7 Injury to multiple nerves at the ankle and foot level
S94.8 Injury to other nerves at the ankle and foot level
S94.9 Injury to unspecified nerve at ankle and foot level
S95 Injury to blood vessels at the level of the ankle and foot
Excluded: injury to the posterior tibial artery and vein ( S85. -)
S95.0 Trauma to the dorsal artery of the foot
S95.1 Trauma to the plantar artery of the foot
S95.2 Trauma to the dorsal vein of the foot
S95.7 Injury to several blood vessels at the ankle and foot level
S95.8 Injury to other blood vessels at the ankle and foot level
S95.9 Injury to unspecified blood vessel at ankle and foot level
S96 Injury to muscle and tendon at ankle and foot level
Excludes: calcaneal [Achilles] tendon injury ( S86.0)
S96.0 Injury to the flexor digitorum longus and its tendon at the level of the ankle and foot
S96.1 Injury to the extensor finger longus and its tendon at the level of the ankle and foot
S96.2 Injury to the intrinsic muscle and tendon at the level of the ankle joint and foot
S96.7 Injury to several muscles and tendons at the ankle and foot level
S96.8 Injury to another muscle and tendon at the ankle and foot level
S96.9 Injury to unspecified muscles and tendons at the ankle and foot level
S97 Crushing ankle and foot
S97.0 Ankle crush
S97.1 Crushed toe(s)
S97.8 Crushing of other parts of the ankle and foot. Crushed foot NOS
S98 Traumatic amputation of the ankle and foot
S98.0 Traumatic amputation of the foot at the level of the ankle joint
S98.1 Traumatic amputation of one toe
S98.2 Traumatic amputation of two or more toes
S98.3 Traumatic amputation of other parts of the foot. Combined traumatic amputation of toe(s) and other parts of the foot
S98.4 Traumatic amputation of the foot at an unspecified level
S99 Other and unspecified injuries of the ankle and foot
S99.7 Multiple ankle and foot injuries
Injuries classified in more than one category S90-S98
S99.8 Other specified ankle and foot injuries
S99.9 Unspecified ankle and foot injury
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Read more >>>S80-S89 Knee and lower leg injuries
Excludes: superficial injury of the hip area (S70.-)
Excludes: open wound of the hip joint area (S71.0) traumatic amputation of part of the abdomen, lower back and pelvis (S38.2 -S38.3)
Included: fracture at the level of the lumbosacral spine. vertebral arches.
spinous process. transverse process.
Excluded: dislocation, sprain and strain of the hip joint and ligaments (S73.-) obstetric trauma of the joints and ligaments of the pelvis (O71.6) ruptures or displacement (non-traumatic) of the intervertebral disc in the lumbar region (M51.-)
The following subcategories are given for optional use for additional characterization of the condition when it is impossible or inappropriate to carry out multiple coding: 0 - without an open wound in the abdominal cavity 1 - with an open wound in the abdominal cavity
The following subcategories are provided for optional use in additional characterization of a condition where multiple coding is impossible or inappropriate: 0 - without an open wound in the abdominal cavity 1 - with an open wound in the abdominal cavity Excludes: trauma to the peritoneum and retroperitoneal space (S36.8)
In cases closed injury Heart bruise accounts for up to seventy percent. A heart exposed to a shock, depending on how severe the damage has occurred, can cope with the consequences on its own or will require the help of doctors. In any case, it is necessary to consult a specialist so as not to waste time if the diagnosis shows the need to undergo treatment.
Internal organs are quite well protected from mechanical damage. However, injuries are possible here too. Kidney bruise is not the most common occurrence and is usually associated with damage to other pelvic organs.
S80 Superficial injury of the leg
S81 Open wound of the leg
S82 Fracture of lower leg bones, including ankle joint
S00 Superficial head injury
S01 Open head wound
S02 Fracture of the skull and facial bones
S03 Dislocation, sprain and strain of joints and ligaments of the head
S04 Cranial nerve injury
S05 Injury to the eye and orbit
An infected wound of the hand, ICD 10 code S61, is a soft tissue injury caused by bacterial agents. Develops after the emergence of pathogenic flora inside the defect cavity. The condition is caused by non-compliance with asepsis rules.
Modern technologies, drugs, qualified doctors help solve the problem of hand injuries without development pathological complications. The situation when a wound becomes infected is rare.
Infected wounds are designated by different ICD 10 codes depending on the location.
The healing process occurs in three stages:
- According to ICD 10, the first stage is manifested by a typical protective reaction to damage - a local increase in body temperature, swelling, pain.
- In the second phase, proliferation of new epidermis occurs. The defect is closed connective tissue. The process will not start. The reason is microorganisms that enter the cavity. Suppuration develops.
- Complete healing will occur after the complications have resolved.
Brushes
Infected wounds of the hand and other areas of the body are divided into several subtypes, which are determined by the mechanism of damage to the skin.
According to the international medical classification, types of wounds are distinguished:
- Cut. Appears due to the impact of a sharp object on soft fabrics brushes The healing of the defect depends on the depth of the damage. Consequences are rare.
- According to the ICD, puncture is formed under the influence of a massive object with a sharp end. It has a large width and length. With an infected lesion, microbes spread with an increase in the area of damage. A person struggles with complications of the disease for a long time.
- A bruised hand is characterized by minimal disruption of the integrity of the skin of the hand. Necrosis occurs due to poor blood supply.
- According to statistics, laceration and bite wounds in 60% of cases are complicated by infection. Bacterial agents enter the defect with the animal's saliva.
- Crushed occurs under the influence of a massive object on the tissue of the hand. There is a high probability of developing toxicosis and infection.
- Gunshot wounds are difficult to treat. The condition of infected wounds threatens the development of consequences. According to the ICD, inflammation and pus discharge are observed.
The hand area is characterized by a developed circulatory system.
The ulnar and radial arteries form many small branches that supply the dorsal and palmar surfaces with blood. If pathogenic microorganisms get inside a wound localized in the hand area, complications may arise. Septic shock during infection develops when bacteria penetrate into the vascular bed.
Finger
An infected finger wound, code according to ICD 10 S61.1, is a lesion of the skin with penetration of bacteria. Occurs when careless use of cutting and piercing instruments in everyday life. Infection of a finger can occur in two ways. In the first case, pathogens of the pathological process enter the damaged epidermis at the time of injury. In the second - when there is a violation of the processing of the defect of the hand and finger.
Healing on the finger depends on the depth of the injury, the degree of infection, and the presence of injured muscles, tendons, and joints. Proper care and timely seeking medical help help prevent the development of sepsis and abscess. Recovery occurs within 2-3 weeks.
Forearms
An infected wound of the forearm, code according to ICD 10 S51.9, is open and superficial. In the first case, the insides of the defect are in contact with the external environment. Multiple injuries pose a danger. They can occupy large areas of the forearm. Superficial is formed due to a bruise. There is a high risk of infection with an open wound, where microbes can freely penetrate a few minutes after traumatizing the skin and spread through the bloodstream into the hand.
The main signs of purulent inflammation of an infected epidermal defect are pronounced redness of the edges of the damaged area, high body temperature, and yellow discharge. On palpation, the pathological area is painful, and the main functions of the injured forearm are disrupted.
Elbow joint
An infected wound of the elbow joint occurs when a person falls on the arm, receives a strong blow, or sutures come apart after surgery. Pathogenic microflora infects cavity tissues after improper treatment.
The elbow joint is responsible for the flexor and extensor muscles. The development of a purulent infected process can result in loss of function due to the rapid spread of infection. Bacteria penetrate into the forearm and hand through anatomical channels and blood.
According to ICD 10 main symptoms infected wound: suppuration, bad smell, swelling, red edges of the damaged surface, high temperature. Without timely treatment, the situation ends with the development of phlegmon or an abscess.
How to treat an infected wound
The pathology is treated in a surgical hospital when the condition is severe. Infected wounds of the hand require an integrated approach to therapy. A course is required that includes antibacterial agents, antiseptics.
The use of antibiotics orally or by injection is indicated for high temperature body, which lasts more than 3 days. According to ICD 10, medications suppress the proliferation of microorganisms within an infected pathology and spread throughout the body. Antimicrobial drugs are semisynthetic penicillins, which have wide range actions. If penicillins are ineffective, they resort to cephalosporins and macrolides.
According to ICD 10, the area of the infected wound requires surgical treatment.
According to ICD 10, the purpose of the procedure is to cleanse the cavity of the hand or other part of the body from contents - necrotic tissue, bacterial agents. The surgical surface is first disinfected with antiseptic drugs. Then they cover it with sterile napkins, numb it, install a drainage, and secure the structure with bandages. Manipulation helps get rid of pus.
Prescribed according to indications antibacterial ointments to enhance the effect in the fight against pathogenic microorganisms and infection. Use Erythromycin, Streptomycin. To strengthen the body's protective functions, immunostimulants are used.
Possible complications and prognosis for recovery
The prognosis of an infected hand wound depends on the depth, degree of infection, localization, and spread to underlying tissues. Under the influence intensive care the patient recovers faster. According to ICD 10, recovery period takes from 2 to 4 weeks.
Advanced cases of infected pathology require long-term treatment. Main complications of the condition according to ICD 10:
- Phlegmon of the hand is a purulent melting of tissue.
- An abscess is a localized area of pus surrounded by a capsule.
- Gas gangrene develops when anaerobic microorganisms that do not need oxygen to reproduce penetrate into the affected area of the hand. Symptom: crepitus when pressing on an infected wound.
- Septic shock according to ICD 10 is characterized by a systemic inflammatory reaction of a weakened body. Caused by the penetration of pathogenic microorganisms into the bloodstream. The situation requires immediate treatment in the intensive care unit.
Clinical manifestations and treatment tactics for damage to the tendons of the hand depend on the location of the wound, its contamination and the degree of soft tissue damage. If the wound is clean, smooth (usually cut) and the soft tissues of the hand are well nourished (no concomitant damage to the arteries), a primary tendon suture is performed.
The earlier the operation is performed, the higher the chances of good wound healing and restoration of tendon function. The optimal time for surgery is within the first 6 hours after injury. The deadline during which the primary suture of the tendon is possible is 24 hours from the moment of damage.
In traumatology, restoring finger function when the hand tendons are damaged is difficult. surgical intervention, which often requires the use of microsurgical techniques. The operation is performed under a tourniquet, with minimal tissue trauma, under local or regional anesthesia (so that the patient can bend his fingers on command while checking tendon repair). IN postoperative period The arm must be fixed with a plaster cast.
In case of extensive damage to soft tissues (lacerations, crushing), significant contamination of the wound and late contact with a traumatologist in case of damage to the tendons of the hand, a delayed secondary tendon suture is performed. The operation is performed as soon as possible after complete healing of the wound.
Isolated injury to the deep flexor tendon. Occurs only when wounded in the area of the nail phalanx. The patient cannot bend the joint located between the nail and middle phalanges. If during the operation it is possible to locate the proximal end of the deep flexor muscle, the tendon is sutured. In cases where the proximal end cannot be found, the peripheral end of the flexor muscle is sutured to the bone of the middle phalanx.
Isolated injury to the superficial flexor tendon. Possible with injuries to the fingers (with the exception of the nail phalanx), damage to the palmar surface of the hand at any level and injury to the lower third of the forearm. The patient cannot bend the joint located between the middle and main phalanges. During the operation, the proximal end of the tendon is found. If necessary, an additional incision is made in the palm, through which the central end of the tendon is brought out into the peripheral wound using a guide.
If the ends of the tendon are crushed or disintegrated, they are excised. In order to prevent postoperative flexion contracture, operations are performed to lengthen the tendon in the tendon-muscular part or to extend it in a Z-shape proximal to the area of damage.
With wounds in the area of the middle and main phalanges of the fingers, and, especially often, with a wound in the palm area, simultaneous damage to the deep and superficial flexors is observed.
Damage to both flexor tendons. There is no flexion at the proximal and distal interphalangeal joint. Only the deep flexor tendons are repaired. The ends of the superficial flexor tendons are excised.
In case of injuries to the lower third of the forearm, damage to the flexor tendons is often combined with a violation of the integrity of the veins, ulnar and median nerves, ulnar and radial arteries, and radial and ulnar flexor tendons.
RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Archive - Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2007 (Order No. 764)
Open wounds involving multiple areas of the body (T01)
general information
Short description
Wound- damage to body tissues due to mechanical impact, accompanied by a violation of the integrity of the skin and mucous membranes.
Protocol code: H-S-026 "Wounds various localizations"
Profile: surgical
Stage: hospital
ICD-10 code(s):
T01 Open wounds involving multiple areas of the body
S21 Open chest wound
S31 Open wound of the abdomen, lower back and pelvis
S41 Open wound of the shoulder girdle and shoulder
S51 Open wound of the forearm
S61 Open wound of wrist and hand
S71 Open wound of the hip joint and thigh
S81 Open wound of the leg
S91 Open wound of the ankle and foot area
S16 Injury to muscles and tendons at the neck level
S19 Other and unspecified neck injuries
S19.7 Multiple neck injuries
S19.8 Other specified neck injuries
S19.9 Neck injury, unspecified
T01.0 Open wounds of the head and neck
T01.1 Open wounds of the chest, abdomen, lower back and pelvis
T01.2 Open wounds of several areas of the upper limb(s)
T01.3 Open wounds of several areas of the lower limb(s)
T01.6 Open wounds of several areas of the upper and lower extremities
T01.8 Other combinations of open wounds involving multiple areas of the body
T01.9 Multiple open wounds, unspecified
Classification
1. Stabbed - as a result of exposure to a sharp object.
2. Cut - as a result of exposure to a sharp long object, no less than 0.5 cm in size.
3. Bruised - as a result of exposure to an object of large mass or high speed.
4. Bitten - as a result of the bite of an animal, less often a person.
5. Scalped - detachment of the skin and subcutaneous tissue from the underlying tissue occurs.
6. Firearms - as a result of the action of a firearm.
Diagnostics
Diagnostic criteria:
Pain syndrome in the injured limb;
Forced position of the injured limb;
Limited or absent limb mobility;
Changes in soft tissue over the fracture site (swelling, hematoma, deformation, etc.);
Crepitation upon palpation of the suspected injured area of the leg;
Associated neurological symptoms (lack of sensitivity, coldness, etc.);
Damage to the skin according to the above classification;
X-ray signs of injury to underlying tissues.
List of main diagnostic measures:
1. Determination of the type of injury in accordance with the given classification.
2. Determination of the degree of dysfunction of the injured organ (range of motion).
3. Clinical examination of the patient (see diagnostic criteria).
4. X-ray examination of the injured lower leg in 2 projections.
5. General analysis blood.
6. General urine analysis.
7. Coagulogram.
8. Biochemistry.
9. HIV, HbsAg, Anti-HCV.
List of additional diagnostic measures:
1. Determination of blood group and Rh factor.
2. Determination of sensitivity to antibiotics.
3. Determination of blood sugar.
Treatment
Treatment tactics
Treatment goals: timely diagnosis wounds taking into account their localization, determination of therapeutic tactics (conservative, surgical), prevention possible complications.
Treatment: the need for anesthesia depends on the type of wound according to the classification. Taking into account the violation of the integrity of the skin, it is necessary to administer tetanus toxoid.
Conservative treatment:
1. Primary debridement wounds.
2. If the wound is not infected, antibiotic prophylaxis is not carried out.
1. Application of primary sutures in the absence of signs of wound infection.
2. Antibiotic prophylaxis is carried out for 3-5 days for wounds received more than 8 hours ago with a high risk of infection:
Moderate and severe wounds;
Wounds reaching a bone or joint;
Hand wounds;
Immunodeficiency state;
Wounds of the external genitalia;
Bite wounds.
3. Surgical treatment of wounds is indicated when damage to a nerve or vascular bundle is confirmed.
The results of multicenter studies have established that the use of antibiotic prophylaxis in patients with wounds reduces the risk of developing purulent-inflammatory complications.
Patients can be divided into 3 risk groups:
1. Injuries with damage to the skin and soft tissue less than 1 cm in length, the wound is clean.
2. Injuries with skin damage more than 1 cm in length in the absence of significant damage to the underlying tissues or significant displacements.
3. Any injuries with severe damage to underlying tissues or traumatic amputation.
Patients of risk groups 1-2 require a dose of antibiotics (as early as possible after injury), mainly with an effect on gram-positive microorganisms. For patients at risk group 3, antibiotics that act on gram-negative microorganisms are additionally prescribed.
Antibiotic prophylaxis regimens:
For patients of risk groups 1-2 - amoxicillin 500 thousand after 6 hours, 5-10 days per os;
Patients of the 3rd risk group - amoxicillin 500 thousand after 6 hours, 5-10 days per os + clavulanic acid 1 tablet 2 times.
List of essential medications:
1. *Amoxicillin tablet 500 mg, 1000 mg; capsule 250 mg, 500 mg
2. *Amoxicillin + clavulanic acid film-coated tablets 500 mg/125 mg, 875 mg/125 mg, powder for preparing a solution for intravenous administration in bottles 500 mg/100 mg, 1000 mg/200 mg
3. *Cefuroxime powder for the preparation of solution for injection in a bottle 750 mg, 1.5 g
4. Ceftazidime - powder for the preparation of solution for injection in a bottle of 500 mg, 1 g, 2 g
5. Ticarcillin + clavulanic acid, lyophilized powder 3000 mg/200 mg for solution for intravenous infusion
6. *Nitrofural 20 mg tablet.
List of additional medications: no.
Indicators of treatment effectiveness: wound healing, restoration of functions of damaged organs.
* - drugs included in the list of essential (vital) medicines.
Hospitalization
Indications for hospitalization: emergency.
Information
Sources and literature
- Protocols for diagnosis and treatment of diseases of the Ministry of Health of the Republic of Kazakhstan (Order No. 764 of December 28, 2007)
- 1. Evidence-based medicine. CLINICAL GUIDELINES for practicing doctors. - Moscow, Geotar-Med. - 2002. - p.523-524 2. Surgery. Guide for doctors and students. - Moscow, Geotar-Med. - 2002. - pp. 576-577 3. National Guideline Clearinghouse. Practice Managment for Prophylactic Antibiotic Use in Open Fracture: Eastern Association for the Surgery of Trauma.- 2000.- p.28 4. National Guideline Clearinghouse. Preoperative Test: the Use of Routine Preoperative Tests for Elective Surgery: Evidence, Methods&Guidance. London.-NICE.- 2003. 108p.
Information
List of developers: Ermanov E.Zh. Scientific Center of Surgery of the Ministry of Health of the Republic of Kazakhstan
Attached files
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