Puncture wound with foreign body of thumb without damage to nail
ICD-10 S61.04 is a billable code used to indicate a diagnosis of puncture wound with foreign body of thumb without damage to nail.
A puncture wound with a foreign body of the thumb occurs when a sharp object penetrates the skin and underlying tissues of the thumb, potentially introducing foreign material into the wound. This type of injury is common in various settings, including workplaces, homes, and recreational areas. The absence of damage to the nail indicates that the injury is limited to the soft tissues of the thumb, which may include the skin, subcutaneous tissue, and possibly deeper structures such as tendons or nerves. Clinically, patients may present with localized pain, swelling, and redness around the wound site. The presence of a foreign body can complicate the healing process and may require surgical intervention for removal. Proper assessment is crucial to determine if there are associated injuries, such as tendon lacerations or nerve damage, which can significantly affect hand function. Treatment typically involves cleaning the wound, removing the foreign body, and monitoring for signs of infection. In some cases, tetanus prophylaxis may be indicated depending on the patient's immunization history.
Detailed notes on the mechanism of injury, foreign body characteristics, and any associated injuries.
Patients presenting with puncture wounds from tools, glass, or other sharp objects.
Ensure documentation reflects the need for surgical intervention if foreign body removal is required.
Comprehensive assessment of the wound, including size, depth, and any signs of infection.
Patients with acute hand injuries from accidents or sports.
Document tetanus status and any immediate care provided.
Used when the wound requires closure after foreign body removal.
Document the size of the wound and the method of closure.
Orthopedic surgeons may need to document any associated tendon repairs.
Document the mechanism of injury, the type of foreign body, the extent of the wound, any associated injuries, and the treatment provided.