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 Guides to the assessment of everlasting Impairment and offers those guidance in quick-reference tabular structure for busy clinicians.
Section One summarizes the strategies and terminology of impairment score. part comprises score tables for the higher extremity, decrease extremity, backbone, pelvis, pores and skin, and soreness. Appendices contain tables for changing scores from one physique half to a different and mixing a number of injuries.
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Extra info for A Concise Guide to Orthopaedic and Musculoskeletal Impairment Ratings
26 out using a dynamometer; if a reliable sequence = is obtained, the result should be a bell-shaped curve for each hand. Thus, if = the patient's injured side is the nondominant side, assume that the grip strength is 10% less than the dominant side. An average for that hand below the calculated 10% decrease due to its being the nondominant hand is the grip strength deficit. Conver= sely, if the injury is to the dominant hand, use the nondomi= nant hand as the baseline and add 10%. Any drop below that figure for the domina= nt hand is the grip strength deficit.
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.
These impairments are a= dded. If the resting position of the hand is = in a position deviated from neutral such that the range of motion is in a less functional arc, the impairment ratings for radial-ulna= r deviation should be increased. ♦ = Example: The patient has dorsiflexion to 30 degrees and palmar flexion to 20 degrees, which is a mild impairment of flexion-extension= of 12%. If radial deviation is 10 degrees and ulnar<= /span> deviation is 15 degrees, then that constitutes a moderate impairment of radial-ulnar deviation of 5%.