ICD-10: S63.433

The ICD-10 code S63.433 refers to a specific type of injury known as the traumatic rupture of the volar plate of the left middle finger, occurring at both the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Here are the clinical details and descriptions associated with this condition:

Clinical Description:

• Volar Plate: The volar plate is a fibrous structure located on the palm side of the finger joints. It plays a crucial role in stabilizing the joints and preventing hyperextension.
• Traumatic Rupture: This injury typically results from a sudden force or trauma, such as a fall or a direct blow to the finger, which can lead to the tearing of the volar plate.
• Affected Joints: The injury specifically involves:
• Metacarpophalangeal Joint: The joint between the metacarpal bones of the hand and the proximal phalanx of the finger.
• Interphalangeal Joint: The joint between the phalanges of the finger.

Symptoms:

• Pain and Swelling: Immediate pain and swelling in the affected finger.
• Limited Range of Motion: Difficulty in bending or straightening the finger due to instability.
• Deformity: Possible visible deformity or abnormal positioning of the finger.

Diagnosis:

• Clinical Examination: A thorough physical examination to assess the range of motion and stability of the finger joints.
• Imaging: X-rays or MRI may be used to confirm the diagnosis and assess the extent of the injury.

Treatment:

• Conservative Management: May include rest, ice, compression, and elevation (RICE), along with splinting to immobilize the finger.
• Surgical Intervention: In cases of severe rupture or instability, surgical repair of the volar plate may be necessary.

Coding Information:

• ICD-10 Code: S63.433A is used for the initial encounter, while S63.433D is used for subsequent encounters. This coding is essential for medical billing and record-keeping purposes.

This injury is classified under the broader category of injuries and poisoning, specifically focusing on traumatic injuries to the ligaments of the fingers [11][15].

The ICD-10 code S63.433 refers to a traumatic rupture of the volar plate of the left middle finger at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. This condition typically presents with a variety of clinical signs and symptoms, as well as specific patient characteristics. Here’s a detailed overview:

Clinical Presentation

• Mechanism of Injury: The injury often occurs due to a traumatic event, such as a fall or a direct blow to the finger, which can lead to hyperextension of the finger joints.
• Pain: Patients usually report significant pain localized to the affected finger, particularly around the MCP and IP joints.
• Swelling: There is often noticeable swelling in the area of the injury, which may extend to the surrounding tissues.
• Bruising: Ecchymosis (bruising) may be present, indicating soft tissue damage.

Signs and Symptoms

• Limited Range of Motion: Patients may experience difficulty in moving the affected finger, particularly in flexion and extension.
• Instability: There may be a feeling of instability in the finger joint, especially when attempting to grasp or hold objects.
• Tenderness: Palpation of the volar plate area typically elicits tenderness, indicating inflammation or injury to the ligament.
• Deformity: In some cases, there may be visible deformity of the finger, particularly if there is associated dislocation or fracture.

Patient Characteristics

• Demographics: This injury can occur in individuals of all ages but is more common in active individuals, including athletes and those engaged in manual labor.
• Activity Level: Patients who participate in sports or activities that involve hand use are at a higher risk for this type of injury.
• Previous Injuries: A history of previous finger injuries may predispose individuals to this condition, as prior damage can weaken the structures of the finger.

Conclusion

In summary, the clinical presentation of a traumatic rupture of the volar plate of the left middle finger at the MCP and IP joints includes significant pain, swelling, limited range of motion, and potential instability of the joint. The injury is often seen in active individuals and can be associated with a history of trauma or previous injuries to the finger. Proper assessment and management are crucial for optimal recovery and function of the affected finger.

The ICD-10 code S63.433, which refers to the traumatic rupture of the volar plate of the left middle finger at the metacarpophalangeal and interphalangeal joint, has several alternative names and related terms. Here are some of them:

• Approximate Synonyms:

• Left middle finger volar plate rupture [1].

• Related ICD-10 Codes:

• S63.432: Traumatic rupture of the volar plate of the right middle finger at the same joints [5].

• S63.43: General code for traumatic rupture of the volar plate of the finger at the metacarpophalangeal and interphalangeal joint [9].

• Descriptive Terms:

• Avulsion of joint or ligament at wrist and hand level [10].
• Laceration of cartilage, joint, or ligament at wrist and hand level [10].

These terms and codes are useful for medical professionals when diagnosing and documenting injuries related to the volar plate of the fingers.

The diagnosis for ICD-10 code S63.433, which refers to the traumatic rupture of the volar plate of the left middle finger at the metacarpophalangeal (MCP) and interphalangeal (IP) joints, is based on specific clinical criteria and diagnostic findings. Here are the key criteria typically used for this diagnosis:

• Clinical Presentation: Patients often present with pain, swelling, and instability in the affected finger. There may be a history of trauma or injury that led to the rupture.

• Physical Examination: A thorough examination of the finger is essential. This includes assessing for tenderness, range of motion, and any signs of joint instability. The presence of a palpable gap or abnormal movement at the MCP or IP joints may indicate a rupture.

• Imaging Studies: X-rays are commonly used to rule out fractures and assess joint alignment. In some cases, advanced imaging such as MRI may be utilized to visualize soft tissue injuries, including the volar plate.

• Functional Assessment: Evaluating the functional impairment of the finger, including the ability to grasp or perform daily activities, can also support the diagnosis.

• Differential Diagnosis: It is important to differentiate this condition from other injuries, such as ligament sprains or fractures, which may present with similar symptoms.

These criteria help healthcare providers confirm the diagnosis of S63.433 and determine the appropriate treatment plan for the patient [10][11][12].

The standard treatment approaches for a traumatic rupture of the volar plate of the left middle finger, as indicated by ICD-10 code S63.433, typically involve both conservative and surgical options, depending on the severity of the injury. Here are the common treatment methods:

Conservative Treatment

• Immobilization: Initially, the affected finger may be immobilized using a splint to prevent movement and allow healing. An extension block splint is often used to maintain the finger in a position that minimizes stress on the volar plate.
• Physical Therapy: Once the initial healing has occurred, physical therapy may be recommended to restore range of motion and strength. This can include exercises to improve flexibility and function of the finger.

Surgical Treatment

• Indications for Surgery: Surgical intervention is typically indicated in cases of significant joint instability or when conservative treatment fails. This is especially true if there is a large avulsion fracture associated with the rupture.
• Surgical Options:
• Reattachment or Repair: The volar plate may be surgically reattached or repaired if it has been torn away from the bone.
• Tendon Grafts: In chronic cases or when there is significant damage, criss-cross volar tendon grafts may be used to reconstruct the volar plate.
• Fixation Techniques: Surgical fixation may involve the use of screws or anchors to stabilize the joint and facilitate healing.

Postoperative Care

• Rehabilitation: After surgery, a structured rehabilitation program is essential to regain function. This may include gradual mobilization and strengthening exercises.
• Follow-Up: Regular follow-up appointments are necessary to monitor healing and adjust treatment as needed.

These treatment approaches aim to restore function and stability to the finger while minimizing the risk of complications such as stiffness or chronic pain [12][14].