By Chris E. Wiggins MD
This easy-to-use handbook is a timesaving advisor to assigning musculoskeletal impairment rankings for laborers reimbursement, own damage, and incapacity claims. It follows many of the rules within the American clinical Association's publications to the review of everlasting Impairment and provides those guidance in quick-reference tabular structure for busy clinicians. part One summarizes the methods and terminology of impairment score. part comprises score tables for the higher extremity, decrease extremity, backbone, pelvis, dermis, and ache. Appendices comprise tables for changing rankings from one physique half to a different and mixing a number of accidents.
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Extra info for A A Concise Guide to Orthopaedic and Musculoskeletal Impairment Ratings
For multiple digits, add (do not combine) the digital impairments to obtain the total hand impairment. Total active motion is determined as follows: ♦ = Total active flexio= n (MP flexion + proximal interphalangeal [PIP] f= lexion + distal interphalangeal [DIP] flexion) - = Total active extension lag (MP extension lag + PIP extension lag + DIP exten= sion lag) =3D TAM Ri= ng or Little Finger Interpolate the values from Table 6-6 for the best fit with the patient's loss of ac= tive motion. <= o:p> Total active motion is determined as follows: ♦ = Total active flexio= n (MP flexion + PIP flexion + DIP flexion) - Total active extension lag (MP extension lag + PIP extension lag + DIP extension lag) =3D TAM Table of Contentso:p 37 38 Table of Contentso:p Di= gital Deformity Only the most severe of the deformities listed in Table 6-7 is to be rated, and it may be combined with a loss of motion rating for the digit.
If = neurologic impairment is the cause of loss of motion,= do not use a loss of motion table. 5 cm of full extension) 75 30 27 16 MP joint in functional position (20–30°) 50 20 18 11 IP joint in functional position (20–30°) 40 16 14 8= Severi= ty<= /o:p> Ankylo= sis/surgi= cal fusion UE, upper extremity; WP, whole pers= on; TAM, total active motion; MP, metacarpophalangeal<= /span>; IP, interphalangeal. 5 cm of full extension) Ankylo= sis/surgi= cal fusion MP joint in functional position (30°) 45 9= 8= 5= PIP joint in functional position (40°) 50 10 9= 5= DIP joint in functional position (20°) 25 5= 5= 3= UE, upper extremity; WP, whole pers= on; TAM, total active motion; MP, metacarpophalangeal<= /span>; PIP, proximal interphalangeal; DIP, distal = interphalangeal.
Multiple injured digi= ts, because of their relative values to the hand (Table 6-8), are not combined; rather, they are converted to hand units and added. In this example, the injured thumb is rated by combining the loss due to amputation, neurologic impairment, and stiffness. Similarly, the injured middle finger is rated by combining t= he three parameters of loss. Each digit is then converted to an impaired hand = unit and added. <= /span> Fu= nctional Units Functional= unit is the te= rm used in the AMA Guides for a plane of motion wi= thin a joint; this manual will also use this term.