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.

Malunion and Nonunion of Fracture


Related Terms

  • Fracture Deformity
  • Nonjoining Fracture

Differential Diagnosis

Specialists

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

Comorbid Conditions

Factors Influencing Duration

Functional difficulty and duration of disability depend on the site and severity of fracture and whether the fracture is a malunion or nonunion.

Medical Codes

ICD-9-CM:
733.81 - Malunion of Fracture
733.82 - Nonunion of Fracture, Psedoarthrosis (Bone)

Overview

© Reed Group
A malunion is a broken (fractured) bone that has healed in an unacceptable position that causes significant impairment or loss of function. A nonunion is a fracture that has failed to heal. Delayed union is when a fracture takes longer than usual to heal (or a nonunion that finally heals). Failure is arbitrarily set at 6 months or longer without radiographic signs of progression toward healing for 3 months.

In malunion, the bone may have healed at a bent angle (angulated), may be rotated out of position, or the fractured ends may be overlapped causing bone shortening.

There are four types of nonunions: hypervascular or hypertrophic nonunion, oligotrophic nonunion, avascular or atrophic nonunion, and synovial pseudarthrosis. Hypervascular or hypertrophic nonunions are subdivided into elephant foot (rich in callus), and horse foot (mildly hypertrophic, with less abundant callus). In oligotrophic nonunions there is no callus, but bone scan reveals vascularity. Avascular or atrophic nonunions (scar tissue with no osteogenic potential) are subdivided into torsion wedge (with an intermediate fragment), comminuted (with one or more necrotic intermediate fragments), and defect (with loss of a fragment). Finally, in synovial pseudarthrosis there is nonunion with a fluid-filled cavity, with formation of a synovial-like membrane and pseudocapsule.

The severity of the injury is a strong factor in the healing process.

Incidence and Prevalence: More than 6% of fractures of the collar bone (clavicle) that are treated nonoperatively result in a nonunion (Robinson).

Nonunions occur in 1.1% of shoulder joint fractures of the proximal humerus, although if there is slippage of the bone ends while healing, prevalence may reach 33% to 100% (Court-Brown).

Scaphoid fractures are a common wrist fracture resulting in nonunion in 10% to 15% of individuals (Boles). Fractures of the fingers (phalanges) that undergo surgical correction proceed to malunion in 9% of individuals and to nonunion in 6% (Van Oosterom).

Following surgery for displaced hip fractures of the femoral neck that require open reduction with internal fixation (ORIF) to repair, more than 10% of individuals will develop a nonunion (Stannard).

Nearly 8% of shin bone (tibia) shaft fractures heal with a malunion that results in limb deformity (Milner), and between 2% and 10% of tibial fractures result in nonunion (Patel). These numbers are decreasing with improved surgical techniques such as intermedullary nailing.

Source: Medical Disability Advisor






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