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S63.5 – Finger Joint Sprain | ICD-10
S63.5 is an ICD-10 diagnosis code for sprain and strain of joints and ligaments of the fingers. It covers ligament injuries without bone fracture.
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S63.5 is an ICD-10 diagnosis code for sprain and strain of joints and ligaments of the fingers. It covers ligament injuries without bone fracture.
Definition and ICD-10 Code S63.5
S63.5 is the official diagnosis code from the ICD-10 classification (International Classification of Diseases, 10th Revision) and refers to sprain and strain of joints and ligaments of the finger(s). This code is used in medical documentation and billing when the ligaments of a finger joint are overstretched or partially torn due to excessive force, without any associated bone fracture.
Anatomical Background
The fingers consist of several small joints stabilised by firm ligament structures. The main joints involved are:
- Metacarpophalangeal joints (MCP joints): Connecting the hand to the first finger bone
- Proximal interphalangeal joints (PIP joints): Connecting the first and second finger bones
- Distal interphalangeal joints (DIP joints): Connecting the second and third finger bones
The collateral ligaments on either side of each joint, along with the volar plate on the palm side, provide joint stability. A sprain or strain occurs when these ligaments are overstretched or partially torn.
Causes
Common causes of finger joint sprains and strains (S63.5) include:
- Sports injuries, particularly in ball sports such as volleyball, basketball, or handball
- Falls onto an outstretched hand
- Direct impact on an extended finger
- Twisting or excessive bending and hyperextension of a finger
- Workplace accidents or everyday injuries
Symptoms
After a finger joint sprain or strain, the following symptoms may occur:
- Pain in the affected joint, especially with movement or pressure
- Swelling and oedema around the joint
- Bruising (haematoma) due to bleeding into the surrounding tissue
- Restricted movement of the affected finger
- Feeling of instability in the joint in more severe ligament injuries
Severity Grades
Ligament injuries are medically classified into three grades of severity:
- Grade I: Overstretching of the ligaments without tearing, mild pain and minor swelling
- Grade II: Partial tear of the ligament with noticeable swelling, tenderness, and slight instability
- Grade III: Complete rupture of the ligament with marked instability and functional impairment
Diagnosis
The diagnosis of a finger joint sprain (S63.5) is established through:
- Clinical examination: Palpation of the joint, assessment of stability and range of motion
- X-ray imaging: To exclude associated bone fractures
- Ultrasound (sonography): For evaluation of the ligament structures
- MRI (magnetic resonance imaging): In unclear cases or when complex injuries are suspected
Treatment
Treatment depends on the severity of the injury:
Conservative Treatment
- RICE protocol: Rest, Ice, Compression, Elevation in the acute phase
- Immobilisation: Using splints or buddy taping for 2–6 weeks depending on severity
- Pain management: Anti-inflammatory medications such as ibuprofen
- Physiotherapy: To restore strength and range of motion
Surgical Treatment
In cases of complete ligament rupture (Grade III) or associated bony avulsion, surgical ligament reconstruction may be necessary. This is particularly relevant for unstable injuries of the thumb metacarpophalangeal joint (commonly known as skier's thumb or gamekeeper's thumb).
Prognosis and Recovery
Mild sprains typically heal within 2–4 weeks. More severe ligament injuries may require 6–12 weeks of recovery. Without appropriate treatment, there is a risk of chronic joint instability or early-onset osteoarthritis. Consistent physiotherapy and rehabilitation are essential for a good long-term outcome.
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), Code S63.5. www.who.int
- American Society for Surgery of the Hand (ASSH): Clinical guidelines on finger ligament injuries. www.assh.org
- Green D P, Hotchkiss R N, Pederson W C: Green's Operative Hand Surgery. Churchill Livingstone, 6th Edition, 2010.
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