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, Radius and Ulna, Distal


Related Terms

  • Barton's Fracture
  • Buckle Fracture
  • Colles Fracture
  • Smith's Fracture
  • Transverse Wrist Fracture
  • Wrist Fracture

Differential Diagnosis

Specialists

  • Hand Surgeon
  • Neurosurgeon
  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Sports Medicine Physician
  • Vascular Surgeon

Comorbid Conditions

Factors Influencing Duration

Loss of reduction, infection, aseptic necrosis, ligament injury, and concomitant carpal injury would lengthen treatment and recovery. Other factors that could influence disability include age, type of fracture, whether the dominant or nondominant hand is involved, stability of the fracture, and job requirements. Compliance with rehabilitation may influence outcome. Disability will be longer when the fracture is distal, or at the joint (intra-articular).

Medical Codes

ICD-9-CM:
813.21 - Closed Fracture of Shaft of Radius (Alone)
813.22 - Closed Fracture of Shaft of Ulna (Alone)
813.23 - Closed Fracture of Radius with Ulna
813.30 - Open Fracture of Shaft of Radius or Ulna, Unspecified
813.31 - Open Fracture of Radius (Alone)
813.33 - Open Fracture of Radius with Ulna
813.40 - Closed Fracture of Lower End of Forearm, Unspecified
813.41 - Colles Fracture, Closed; Smiths Fracture
813.42 - Fracture, Distal End of Radius, Other (Alone), Closed
813.43 - Fracture, Distal End of Ulna (Alone), Closed
813.44 - Fracture, Radius with Ulna, Lower End, Closed
813.45 - Torus Fracture of Radius (alone)
813.50 - Fracture, Lower End of Forearm, Unspecified, Open
813.51 - Colles Fracture, Open
813.52 - Open Fracture of Distal End of Radius, Other (Alone)
813.53 - Open Fracture of Distal End of Ulna (Alone)
813.54 - Open Fracture of Radius with Ulna, Lower End
813.80 - Closed Fracture of Forearm, Unspecified Part
813.81 - Closed Fracture of Radius (Alone), Unspecified Part
813.82 - Closed Fracture of Ulna (Alone), Unspecified Part
813.83 - Closed Fracture of Radius with Ulna, Unspecified Part
813.90 - Open Fracture of Forearm, Unspecified Part
813.91 - Open Fracture of Radius (Alone), Unspecified Part
813.92 - Open Fracture of Ulna (Alone), Unspecified Part
813.93 - Open Fracture of Radius with Ulna, Unspecified Part

Ability to Work (Return to Work Considerations)

If the fracture is unstable, the arm should not be used for several weeks except for finger range of motion exercises without resistance. The wrist should not be rotated until the fracture is healed. Lifting, carrying, pulling, and pushing should be limited. Use of a cast, splint, external fixation, and/or sling will affect dexterity; therefore, if the dominant side is injured, work restrictions may be more extensive (e.g., if an individual is right-handed and must write or perform fine motor skills with the dominant hand, he or she will experience more work limitations than if the nondominant left hand were injured). In some cases, alternatives to a standard keyboard such as speech recognition software or one-handed keyboards may be appropriate accommodations. Some individuals may find ergonomically adjusted or pneumatic tools useful during the healing period. Rest periods for elevation of the hand and forearm may be necessary during the initial stage of recovery. Company policy on medication usage should be reviewed to determine if pain medication use is compatible with job safety and function.

Symptoms of stiffness may require 12 months for improvement. It is important to understand that the duration guides address return to work but not resolution of symptoms. Depending on the facture and the healing, some individuals may have permanent symptoms. Permanent symptoms do not mean they cannot work, only that they may have symptoms with or without activities.

Risk: Risk for injury is dependent on facture stability. Fracture stability is a combination of the original injury and the medical or surgical treatment. For example after ORIF and plate fixation the fracture may be very stable allowing for only a splint for support and an early return to modified work. Alternatively, the fracture may be commutated and despite ORIF require a long arm cast and very limited use of the limb. Therefore the risk of reinjury varies and this is why the treating physician must understand the concepts of risk, capacity, and tolerance (explained in "Work Ability and Return to Work," pages 9-21).

Capacity: Capacity is an issue once the fracture has healed and risk is no longer an issue. Capacity will also be influenced by age and co-morbidities. Capacity may also be influenced by the employer's job requirements. For example, the patient with a cast on may not be able to return to work as a cook, since the cook has to wash his or her hands before preparing food. However, a retail store greeter or a cashier could return to work with a cast on.

Tolerance: Tolerance early after the fracture will also be affected by fracture stability and the treatment method. Pain will be related to the severity of the injury. Motivation and employer willingness to accommodate are key.

Accommodations: Temporary modification of activities, but not total absence of activity, improves fracture healing. Fracture healing requires a certain amount of stress for bone formation. A change in job duties, sharing or alternating tasks, and limiting time can reduce unnecessary disability. For more information, please refer to "Work Ability and Return to Work," pages 177-228.

Source: Medical Disability Advisor






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