ICD-10: S63.428

Traumatic rupture of palmar ligament of other finger at metacarpophalangeal and interphalangeal joint

Clinical Information

Inclusion Terms

  • Traumatic rupture of palmar ligament of specified finger with unspecified laterality at metacarpophalangeal and interphalangeal joint

Additional Information

Description

The ICD-10 code S63.428 refers to a specific type of injury characterized as a traumatic rupture of the palmar ligament of other fingers at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. This injury is significant in clinical practice due to its implications for hand function and the potential need for surgical intervention.

Clinical Description

Definition

A palmar ligament rupture occurs when the ligaments that stabilize the joints of the fingers are torn due to trauma. The palmar ligaments are crucial for maintaining the integrity and function of the MCP and IP joints, which are essential for gripping and manipulating objects.

Mechanism of Injury

The rupture typically results from:
- Acute trauma: This can include falls, sports injuries, or accidents where the finger is subjected to excessive force or awkward positioning.
- Chronic stress: Repetitive strain or overuse can also lead to ligamentous injuries, although this is less common for acute ruptures.

Symptoms

Patients with a traumatic rupture of the palmar ligament may present with:
- Pain and swelling: Localized around the affected joint.
- Instability: Difficulty in stabilizing the finger during movement.
- Decreased range of motion: Limited ability to flex or extend the finger.
- Bruising: Discoloration may appear around the joint area.

Diagnosis

Diagnosis typically involves:
- Clinical examination: Assessing the range of motion, stability, and pain response.
- Imaging studies: X-rays may be used to rule out fractures, while ultrasound or MRI can provide detailed views of soft tissue injuries, including ligament ruptures.

Treatment Options

Conservative Management

In cases where the injury is not severe, treatment may include:
- Rest and immobilization: Using splints or casts to stabilize the finger.
- Ice therapy: To reduce swelling and pain.
- Physical therapy: To restore function and strength once the initial pain subsides.

Surgical Intervention

For complete ruptures or cases where conservative treatment fails, surgical options may be necessary:
- Repair of the ligament: This may involve suturing the torn ends of the ligament back together.
- Reconstruction: In cases of significant damage, reconstructive techniques may be employed to restore function.

Prognosis

The prognosis for recovery from a traumatic rupture of the palmar ligament largely depends on the severity of the injury and the timeliness of treatment. Early intervention typically leads to better outcomes, with most patients regaining full function of the finger.

Conclusion

The ICD-10 code S63.428 encapsulates a specific and clinically significant injury involving the palmar ligament of the fingers. Understanding the mechanisms, symptoms, and treatment options is crucial for healthcare providers in managing this condition effectively. Prompt diagnosis and appropriate management can significantly enhance recovery and restore hand function.

Clinical Information

The ICD-10 code S63.428 refers to a traumatic rupture of the palmar ligament of other fingers at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for accurate diagnosis and management.

Clinical Presentation

Mechanism of Injury

Traumatic rupture of the palmar ligament typically occurs due to a sudden force or trauma to the finger, often during sports activities, falls, or accidents. The injury may result from hyperextension or direct impact, leading to the ligament's failure.

Patient Characteristics

  • Demographics: This injury can occur in individuals of all ages but is more prevalent in active young adults and athletes, particularly those involved in contact sports or activities that require gripping.
  • Occupation: Individuals in occupations that involve manual labor or repetitive hand movements may also be at higher risk.

Signs and Symptoms

Pain

  • Localized Pain: Patients often report acute pain localized to the affected finger, particularly around the MCP and IP joints.
  • Radiating Pain: Pain may radiate along the finger or into the hand, depending on the extent of the injury.

Swelling and Bruising

  • Swelling: Immediate swelling around the joint is common, indicating inflammation and possible hematoma formation.
  • Bruising: Ecchymosis may develop over time, particularly if there is associated soft tissue injury.

Functional Impairment

  • Reduced Range of Motion: Patients may experience limited range of motion in the affected finger, particularly in flexion and extension.
  • Instability: There may be a sensation of instability in the joint, especially when attempting to grip or apply pressure.

Deformity

  • Joint Deformity: In severe cases, there may be visible deformity of the finger, particularly if there is associated dislocation or significant ligamentous injury.

Tenderness

  • Palpation Tenderness: Tenderness is typically noted upon palpation of the palmar aspect of the affected joint, where the ligament is located.

Diagnosis

Physical Examination

  • Joint Stability Tests: Clinicians may perform specific tests to assess the stability of the MCP and IP joints, checking for excessive movement that indicates ligamentous injury.
  • Range of Motion Assessment: Evaluating the active and passive range of motion helps determine the extent of the injury.

Imaging Studies

  • X-rays: Radiographs are often performed to rule out fractures or dislocations associated with the ligament injury.
  • MRI or Ultrasound: These imaging modalities may be utilized to assess the integrity of the palmar ligament and surrounding soft tissues.

Conclusion

Traumatic rupture of the palmar ligament at the MCP and IP joints presents with characteristic signs and symptoms, including localized pain, swelling, functional impairment, and potential joint instability. Understanding the clinical presentation and patient characteristics is essential for healthcare providers to ensure accurate diagnosis and effective treatment. Early intervention can help restore function and prevent long-term complications associated with this injury.

Approximate Synonyms

The ICD-10 code S63.428 refers to a specific injury involving the traumatic rupture of the palmar ligament in the fingers, particularly at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Understanding alternative names and related terms for this condition can be beneficial for medical professionals, coders, and researchers. Below are some relevant terms and alternative names associated with this injury.

Alternative Names

  1. Palmar Ligament Rupture: This term directly describes the injury, focusing on the rupture of the palmar ligament without specifying the location.

  2. Collateral Ligament Injury: While this term generally refers to injuries of the collateral ligaments, it can sometimes be used interchangeably in the context of palmar ligament injuries, especially in discussions about finger stability.

  3. Finger Ligament Tear: A more general term that encompasses any tear in the ligaments of the fingers, including the palmar ligament.

  4. MCP Joint Ligament Injury: This term specifies the injury at the metacarpophalangeal joint, which is relevant for understanding the location of the rupture.

  5. Interphalangeal Joint Ligament Injury: Similar to the above, this term focuses on injuries occurring at the interphalangeal joints.

  1. Traumatic Finger Injury: A broader category that includes various types of injuries to the fingers, including fractures, dislocations, and ligament injuries.

  2. Finger Sprain: While a sprain typically refers to a stretching or tearing of ligaments, it can sometimes be used to describe less severe injuries to the palmar ligament.

  3. Digital Ligament Injury: This term encompasses injuries to the ligaments of the fingers (digits), including both palmar and collateral ligaments.

  4. Hand Injury: A general term that includes any injury to the hand, which may involve ligaments, tendons, bones, or soft tissues.

  5. Ligamentous Injury of the Hand: This term refers to injuries affecting the ligaments in the hand, which can include the palmar ligament.

Conclusion

Understanding the alternative names and related terms for ICD-10 code S63.428 can enhance communication among healthcare providers and improve the accuracy of medical coding and documentation. These terms can also aid in patient education and understanding of their condition. If you need further details or specific information regarding treatment or management of this injury, feel free to ask!

Diagnostic Criteria

The ICD-10 code S63.428 pertains to the diagnosis of a traumatic rupture of the palmar ligament of other fingers at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Understanding the criteria for diagnosing this condition involves a combination of clinical evaluation, imaging studies, and specific diagnostic criteria.

Clinical Evaluation

Patient History

  • Mechanism of Injury: The diagnosis often begins with a detailed patient history that includes the mechanism of injury. Common causes include sports injuries, falls, or accidents where the finger is subjected to excessive force or hyperextension.
  • Symptoms: Patients typically report pain, swelling, and instability in the affected finger. They may also experience difficulty in movement or a sensation of the finger "giving way."

Physical Examination

  • Inspection: The clinician will inspect the finger for swelling, bruising, or deformity.
  • Palpation: Tenderness over the palmar ligament and the joints involved is assessed. The clinician may also check for any abnormal movement or instability in the joint.
  • Range of Motion: The range of motion at the MCP and IP joints is evaluated to determine the extent of the injury.

Imaging Studies

X-rays

  • Fracture Assessment: X-rays are typically performed to rule out associated fractures, which can occur alongside ligament injuries. They help in visualizing the alignment of the bones and any potential bony avulsions.

MRI or Ultrasound

  • Soft Tissue Evaluation: In cases where the diagnosis is uncertain, or to assess the extent of the ligament injury, MRI or ultrasound may be utilized. These imaging modalities provide detailed views of soft tissue structures, including ligaments, and can confirm the diagnosis of a rupture.

Diagnostic Criteria

ICD-10 Guidelines

  • The ICD-10-CM code S63.428 specifically indicates a traumatic rupture of the palmar ligament of other fingers. The criteria for this diagnosis include:
  • Traumatic Event: Evidence of a traumatic event leading to the injury.
  • Clinical Signs: Presence of clinical signs consistent with ligament rupture, such as pain, swelling, and instability.
  • Imaging Confirmation: If necessary, imaging studies that confirm the diagnosis of a rupture without significant bony injury.

Differential Diagnosis

  • It is essential to differentiate this injury from other conditions such as:
  • Sprains: Less severe injuries to the ligament.
  • Fractures: Bony injuries that may accompany ligament injuries.
  • Tendon Injuries: Injuries to the flexor or extensor tendons that may present similarly.

Conclusion

The diagnosis of a traumatic rupture of the palmar ligament at the MCP and IP joints, coded as S63.428, relies on a thorough clinical evaluation, appropriate imaging studies, and adherence to ICD-10 diagnostic criteria. Accurate diagnosis is crucial for determining the appropriate treatment plan, which may include conservative management or surgical intervention depending on the severity of the injury and the patient's functional needs.

Treatment Guidelines

The ICD-10 code S63.428 refers to a traumatic rupture of the palmar ligament of other fingers at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. This type of injury can significantly impact hand function and requires a comprehensive treatment approach. Below, we explore standard treatment strategies for this condition.

Understanding the Injury

Anatomy and Function

The palmar ligaments, also known as the volar plates, are critical structures that stabilize the MCP and IP joints. They prevent hyperextension and contribute to the overall stability of the fingers during gripping and pinching activities. A traumatic rupture can occur due to direct trauma, falls, or sports injuries, leading to pain, swelling, and instability in the affected finger.

Standard Treatment Approaches

Initial Assessment

  1. Clinical Evaluation: A thorough physical examination is essential to assess the extent of the injury, including range of motion, stability of the joints, and any associated injuries (e.g., fractures).
  2. Imaging Studies: X-rays are typically performed to rule out fractures. In some cases, MRI may be indicated to evaluate soft tissue injuries more comprehensively.

Conservative Management

For less severe cases or when surgery is not immediately necessary, conservative treatment may be sufficient:

  1. Rest and Activity Modification: Avoiding activities that exacerbate pain is crucial. Patients are often advised to limit the use of the affected finger.
  2. Immobilization: A splint or buddy taping may be used to immobilize the finger and allow for healing. This helps to stabilize the joint and prevent further injury.
  3. Ice Therapy: Applying ice packs can help reduce swelling and alleviate pain in the acute phase of the injury.
  4. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can be prescribed to manage pain and inflammation.

Surgical Intervention

In cases where conservative management fails or if the injury is severe, surgical intervention may be necessary:

  1. Repair of the Ligament: Surgical repair involves suturing the torn ligament back to its anatomical position. This is typically performed under local or general anesthesia.
  2. Reconstruction: In cases of significant ligament damage or chronic instability, reconstruction using grafts may be required to restore function and stability to the joint.

Postoperative Rehabilitation

Following surgery, a structured rehabilitation program is essential for optimal recovery:

  1. Physical Therapy: A physical therapist will guide the patient through exercises to regain strength, flexibility, and range of motion. This may include:
    - Passive and active range of motion exercises.
    - Strengthening exercises as healing progresses.
  2. Gradual Return to Activities: Patients are typically advised to gradually return to normal activities, with specific guidelines on when to resume sports or heavy lifting.

Monitoring and Follow-Up

Regular follow-up appointments are crucial to monitor healing and adjust the rehabilitation program as needed. This ensures that any complications, such as stiffness or re-rupture, are addressed promptly.

Conclusion

The treatment of a traumatic rupture of the palmar ligament at the MCP and IP joints involves a combination of conservative management and, if necessary, surgical intervention. Early assessment and appropriate treatment are vital for restoring function and minimizing long-term complications. Patients should engage in a comprehensive rehabilitation program to ensure a successful recovery and return to daily activities.

Related Information

Description

  • Traumatic rupture of palmar ligament
  • Injury to MCP and IP joints
  • Palmar ligaments are crucial for finger function
  • Typically results from acute trauma or chronic stress
  • Symptoms include pain, swelling, instability, decreased range of motion
  • Diagnosis involves clinical examination and imaging studies
  • Treatment options include conservative management and surgical intervention

Clinical Information

  • Traumatic rupture of palmar ligament common
  • Occurs due to sudden force or trauma
  • More prevalent in active young adults
  • Pain is acute and localized
  • Swelling and bruising are immediate symptoms
  • Reduced range of motion and instability occur
  • Joint deformity may be present in severe cases
  • Palpation tenderness is noted at affected joint

Approximate Synonyms

  • Palmar Ligament Rupture
  • Collateral Ligament Injury
  • Finger Ligament Tear
  • MCP Joint Ligament Injury
  • Interphalangeal Joint Ligament Injury
  • Traumatic Finger Injury
  • Finger Sprain
  • Digital Ligament Injury
  • Hand Injury
  • Ligamentous Injury of the Hand

Diagnostic Criteria

  • Traumatic event causing ligament rupture
  • Clinical signs: pain, swelling, instability
  • Imaging confirmation without significant bony injury

Treatment Guidelines

  • Clinical evaluation of range of motion
  • Imaging studies with X-rays or MRI as needed
  • Rest and activity modification to avoid exacerbating pain
  • Immobilization with splint or buddy taping
  • Ice therapy to reduce swelling and pain
  • Pain management with NSAIDs if necessary
  • Surgical repair of ligament in severe cases
  • Reconstruction with grafts for chronic instability
  • Postoperative rehabilitation with physical therapy
  • Gradual return to activities with specific guidelines

Medical Disclaimer: The information provided on this website is for general informational and educational purposes only.

It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.