Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Fracture, Femoral Neck


Related Terms

  • Broken Hip
  • Hip Fracture
  • Intracapsular Fracture of the Femoral Neck
  • Pauwel's Fracture
  • Unsolved Fracture

Differential Diagnosis

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist

Comorbid Conditions

Factors Influencing Duration

Factors influencing length of disability include the location and type of fracture; the cause of the fracture; the presence of any underlying diseases or pathologic conditions that precipitated the fracture; the specific treatment or surgical intervention provided; the development of complications; and the individual's age, general health, and ability to ambulate after surgery. Individual job requirements, and whether individual performs work while seated or standing, also affect length of disability.

Medical Codes

ICD-9-CM:
820.00 - Closed Fracture of Intracapsular Section of Neck of Femur, Unspecified
820.01 - Closed Fracture of Epiphysis of Neck of Femur
820.02 - Closed Fracture of Mid-cervical Section of Neck of Femur
820.03 - Closed Fracture of Base of Neck of Femur, Cervicotrochanteric Section
820.09 - Closed Transcervical Fracture of Neck of Femur, Other
820.10 - Open Fracture of Unspecified Intracapsular Section of Neck of Femur
820.11 - Open Fracture of Epiphysis of Neck of Femur
820.12 - Open Fracture of Mid-cervical Section of Neck of Femur
820.13 - Open Fracture of Base of Neck of Femur
820.19 - Open Transcervical Fracture of Femur, Other
820.8 - Closed Fracture of Neck of Femur, Unspecified Part
820.9 - Open Fracture of Neck of Femur, Unspecified Part

Rehabilitation

Rehabilitation of femoral neck fracture involves physical therapy designed to promote ambulation, increase range of motion, and improve muscle strength. Therapy will depend on the method used to stabilize the fracture, such as closed reduction percutaneous pinning, open reduction and internal fixation (nailing), or (partial) joint replacement (LaVelle). There is no benefit for pre-operative traction (Oliver). Dietetic assistance may improve recovery in older individuals (Avenell; Oliver; Khan). In some cases, bisphosphonates may be needed to facilitate bone regrowth during recovery (Hegmann, "Hip and Groin Disorders - Hip fracture [Medications]").

The primary goal of rehabilitation is early mobilization which includes ambulation and resumption of activities of daily living (Koval). To achieve this goal the individual may require assistive devices for gait training with weight bearing determined by the physician's protocol. Ideally, partial to full weight bearing can be expected immediately after surgery (Koval). The progression from walker to crutches to cane is based on weight bearing status, balance, and strength. Some older individuals may require transfer to rehabilitation facilities to receive inpatient physical therapy prior to home discharge.

The pre-operative status of the individual and physician protocol will dictate the amount of reconditioning needed after surgery. Refer to Total Hip Replacement for details on recovery following partial joint replacement. Individuals with internal fixation are usually able to begin partial weight bearing early, depending on the extent of the surgery (LaVelle). For many individuals who sustain a femoral neck fracture, gait and transfer training will be sufficient to regain their preoperative status. General conditioning of the upper extremities and uninvolved lower extremity may help to facilitate early mobilization and transfers. Ankle range of motion exercises of the involved extremity promotes circulation. Aquatic therapy may be useful for some individuals who do not progress with land therapy (Bartels). Insufficient evidence exists regarding the need for targeted reconditioning of the involved lower extremity (Handoll); however, postoperative therapy emphasizing strengthening and cardiovascular fitness is recommended for those with persistent weakness (Hegmann, "Hip and Groin Disorders - Hip fracture [Activity Modification]"). The goal is to achieve full range of motion, strength, and balance in the involved leg.

Additional information may provide greater insight into the rehabilitation needs of these individuals (Cameron; Handoll).

FREQUENCY OF REHABILITATION VISITS
Surgical
SpecialistFracture, Femoral Neck
Physical TherapistInpatient: daily
Physical TherapistOutpatient: up to 8 visits within 4 weeks
The table above represents a range of the usual acceptable number of visits for uncomplicated cases. It provides a framework based on the duration of tissue healing time and standard clinical practice.

Source: Medical Disability Advisor






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