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, Patella


Related Terms

  • Broken Kneecap
  • Fracture of Kneecap
  • Kneecap Fracture

Differential Diagnosis

  • Bipartite patella
  • Tripartite patella

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physical Therapist
  • Sports Medicine Physician

Comorbid Conditions

Factors Influencing Duration

The disability period for patellar fractures depends on whether the fracture is displaced or nondisplaced and whether surgery has been performed. Other factors influencing duration include the presence of complications or any associated injuries to the knee, the individual's adherence to the prescribed treatment plan, job requirements, and the employer’s ability to modify work activities to protect the knee.

Medical Codes

ICD-9-CM:
822.0 - Closed Fracture of Patella
822.1 - Open Fracture of Patella

Rehabilitation

The goals of rehabilitation after a patellar fracture are to reduce pain and to restore function of the involved limb. The rehabilitation protocol depends upon the type, severity, and operative or nonoperative management of the fracture. If the fracture is managed operatively, postoperative rehabilitation is guided by the treating physician.

Regardless of how the fracture is managed, the knee may be immobilized for a certain period of time (Archdeacon). The physician will indicate when the immobilizer can be removed for exercise and to progress range of motion.

Early rehabilitation includes gait training with assistive devices, such as canes or crutches, as needed. Individuals are immediately instructed in exercises to prevent loss of motion and strength in adjacent joints. Ankle exercises are taught to promote circulation, and individuals are encouraged to perform these intermittently. Modalities including heat and cold can be used to control pain and edema. As guided by the treating physician, range of motion, strengthening, and proprioceptive exercises of the involved joint can be initiated and progressed as indicated and tolerated by the individual (Archdeacon). Once the fracture is healed, exercises are continued until flexibility and strength are restored in the knee joint, a normal gait pattern is observed, and full function returns.

A home program should be taught to complement supervised rehabilitation and to be continued after the completion of physical therapy.

Occupational therapy may be recommended to maximize independence in activities of daily living. An ergonomic assessment may be indicated to assess the workplace and suggest adaptations to allow the individual to return to work. A total patellectomy results in instability with running and some loss of extensor muscle strength; consequently, sports and other vigorous activities may be restricted for up to 6 months following patellectomy (Archdeacon).

FREQUENCY OF REHABILITATION VISITS
Nonsurgical
SpecialistFracture, Patella
Physical or Occupational TherapistUp to 24 visits within 12 weeks
Surgical
SpecialistFracture, Patella
Physical or Occupational TherapistUp to 16 visits within 8 weeks
Note on Nonsurgical Guidelines: Rehabilitation may not begin until tissue healing, about 6 to 8 weeks after the fracture.
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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