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.

Reduction of Fracture or Dislocation


Related Terms

  • Closed Reduction
  • Closed Reduction and Internal Fixation
  • CRIF
  • Manipulative Reduction
  • Open Reduction and Internal Fixation
  • ORIF

Specialists

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

Comorbid Conditions

  • Diabetes
  • Inflammatory conditions
  • Injury to muscles, nerves, and/or arteries
  • Neurologic conditions
  • Obesity
  • Osteoarthritis
  • Osteoporosis
  • Renal disease

Factors Influencing Duration

Type of injury, type of reduction, need for surgery, work requirements, extremity involved, and injury to a dominant hand or arm will affect duration of disability. Fractures heal less quickly and are more likely to change position (slip) as individuals age, requiring more extensive care. Some fractures heal more slowly and have a higher rate of non-union in smokers. Some dislocations, especially of shoulders and kneecaps (patellae), are more prone to repeat injury in younger individuals. Response to procedure, individual healing time based on health status (e.g., nutritional status, presence of chronic conditions such as diabetes or arthritis), and degree of compliance with after-care requirements can influence duration.

Medical Codes

ICD-9-CM:
03.53 - Repair of Vertebral Fracture; Elevation of Spinal Bone Fragments; Reduction of Fracture of Vertebrae; Removal of Bony Spicules from Spinal Canal
79.00 - Closed Reduction of Fracture without Internal Fixation, Unspecified Site
79.02 - Closed Reduction of Fracture without Internal Fixation, Radius and Ulna, Arm NOS
79.03 - Closed Reduction of Fracture without Internal Fixation, Carpals and Metacarpals, Hand NOS
79.04 - Closed Reduction of Fracture without Internal Fixation, Phalanges of Hand
79.05 - Closed Reduction of Fracture without Internal Fixation, Femur
79.06 - Closed Reduction of Fracture without Internal Fixation, Tibia and Fibula, Leg NOS
79.07 - Closed Reduction of Fracture without Internal Fixation, Tarsals and Metatarsals, Foot NOS
79.08 - Closed Reduction of Fracture without Internal Fixation, Phalanges of Foot
79.09 - Closed Reduction of Fracture without Internal Fixation, Other Specified Bone
79.10 - Closed Reduction of Fracture with Internal Fixation, Unspecified Site
79.11 - Closed Reduction of Fracture with Internal Fixation, Humerus
79.12 - Closed Reduction of Fracture with Internal Fixation, Radius and Ulna, Arm NOS
79.13 - Closed Reduction of Fracture with Internal Fixation, Carpals and Metacarpals, Hand NOS
79.14 - Closed Reduction of Fracture with Internal Fixation, Phalanges of Hand
79.15 - Closed Reduction of Fracture with Internal Fixation, Femur
79.16 - Closed Reduction of Fracture with Internal Fixation, Tibia and Fibula, Leg NOS
79.17 - Closed Reduction of Fracture with Internal Fixation, Tarsals and Metatarsals, Foot NOS
79.18 - Closed Reduction of Fracture with Internal Fixation, Phalanges of Foot
79.19 - Closed Reduction of Fracture with Internal Fixation, Other Specified Bone
79.20 - Open Reduction of Fracture without Internal Fixation, Unspecified Site
79.21 - Open Reduction of Fracture without Internal Fixation, Humerus
79.22 - Open Reduction of Fracture without Internal Fixation, Radius and Ulna, Arm NOS
79.23 - Open Reduction of Fracture without Internal Fixation, Carpals and Metacarpals, Hand NOS
79.24 - Open Reduction of Fracture without Internal Fixation, Phalanges of Hand
79.25 - Open Reduction of Fracture without Internal Fixation, Femur
79.26 - Open Reduction of Fracture without Internal Fixation, Tibia and Fibula, Leg NOS
79.27 - Open Reduction of Fracture without Internal Fixation, Tarsals and Metatarsals, Foot NOS
79.28 - Open Reduction of Fracture without Internal Fixation, Phalanges of Foot
79.29 - Open Reduction of Fracture without Internal Fixation, Other Specified Bone
79.30 - Open Reduction of Fracture with Internal Fixation, Unspecified Site
79.31 - Open Reduction of Fracture with Internal Fixation, Humerus
79.32 - Open Reduction of Fracture with Internal Fixation, Radius and Ulna, Arm NOS
79.33 - Open Reduction of Fracture with Internal Fixation, Carpals and Metacarpals, Hand NOS
79.34 - Open Reduction of Fracture with Internal Fixation, Phalanges of Hand
79.35 - Open Reduction of Fracture with Internal Fixation, Femur
79.36 - Open Reduction of Fracture with Internal Fixation, Tibia and Fibula, Leg NOS
79.37 - Open Reduction of Fracture with Internal Fixation, Tarsals and Metatarsals, Foot NOS
79.38 - Open Reduction of Fracture with Internal Fixation, Phalanges of Foot
79.39 - Open Reduction of Fracture with Internal Fixation, Other Specified Bone
79.40 - Closed Reduction of Separated Epiphysis, Unspecified Site
79.41 - Closed Reduction of Separated Epiphysis, Humerus
79.42 - Closed Reduction of Separated Epiphysis, Radius and Ulna, Arm NOS
79.45 - Closed Reduction of Separated Epiphysis, Femur
79.46 - Closed Reduction of Separated Epiphysis, Tibia and Fibula, Leg NOS
79.49 - Closed Reduction of Separated Epiphysis, Other Specified Bone
79.50 - Open Reduction of Separated Epiphysis, Unspecified Site
79.51 - Open Reduction of Separated Epiphysis, Humerus
79.52 - Open Reduction of Separated Epiphysis, Radius and Ulna, Arm NOS
79.55 - Open Reduction of Separated Epiphysis, Femur
79.56 - Open Reduction of Separated Epiphysis, Tibia and Fibula, Leg NOS
79.59 - Open Reduction of Separated Epiphysis, Other Specified Bone
79.70 - Closed Reduction of Dislocation of Unspecified Site
79.71 - Closed Reduction of Dislocation of Shoulder
79.72 - Closed Reduction of Dislocation of Elbow
79.73 - Closed Reduction of Dislocation of Wrist
79.74 - Closed Reduction of Dislocation of Hand and Finger
79.75 - Closed Reduction of Dislocation of Hip
79.76 - Closed Reduction of Dislocation of Knee
79.77 - Closed Reduction of Dislocation of Ankle
79.78 - Closed Reduction of Dislocation of Foot and Toe
79.79 - Closed Reduction of Dislocation of Other Specified Sites
79.80 - Open Reduction of Dislocation of Unspecified Site
79.81 - Open Reduction of Dislocation of Shoulder
79.82 - Open Reduction of Dislocation of Elbow
79.83 - Open Reduction of Dislocation of Wrist
79.84 - Open Reduction of Dislocation of Hand and Finger
79.85 - Open Reduction of Dislocation of Hip
79.86 - Open Reduction of Dislocation of Knee
79.87 - Open Reduction of Dislocation of Ankle
79.88 - Open Reduction of Dislocation of Foot and Toe
79.89 - Open Reduction of Dislocation of Other Specified Sites

How Procedure is Performed

In a closed fracture reduction, after examination of the skin, nerve function, and circulation, an x-ray is taken to determine the current position of the fracture fragments. Often an x-ray of the opposite or uninjured side is also taken and used as a guide during the reduction.

Conscious sedation and local or regional anesthesia may be used to control pain and to promote muscle relaxation. The physician applies pressure above and below the fracture, often with assistance by a person or device to maintain traction on the muscles around the fracture. First, the fragments are bent in the direction of the fracture (slightly exaggerating the deformity) and then lifted into correct position. Position is first maintained manually while nerve and tendon function and circulation are checked. A cast or splint is then used to hold the bone fragments in the correct position. A final x-ray confirms the position of the fragments. If alignment is not correct, the procedure may be repeated or the individual scheduled for an open reduction with possible fixation of the fragments. Repeat x-rays and changes of the cast are done over the next several weeks because the reduction may move out of position (slip) or the bone may begin to heal incorrectly. Initially a splint or half cast may be used to avoid problems with swelling. A full cast is applied after the swelling has decreased, often after 7 to 10 days. Closed reductions are most often done in the emergency room, physician's office, or outpatient surgical setting.

An open reduction or ORIF is done when a closed reduction is not possible or when the fracture is complicated by a wound. This is an inpatient or outpatient surgical procedure performed in the operating room. An incision is made over the fracture, wounds are cleaned, and the fracture position is corrected with pressure. Sometimes the reduced position is maintained with orthopedic hardware such as screws, plates, and rods, placed through or around the fracture fragments (internal fixation). An external fixator device may be used to maintain position. The fixator is composed of pins or rods through the skin and bone, and the free ends of the rods are then attached to a long bar on the outside of the skin. This device can allow for early motion of the joints above and/or below the fracture. It is always eventually removed, often in the physician's office, while internal hardware may be left in place. If internal hardware is to be removed, another surgical procedure is required.

In reducing dislocations, x-rays are done first to confirm the position of the bones and to rule out a fracture combined with the dislocation. If there is only a dislocation, medication is given to control pain and relax the muscles around the dislocation. Gentle stretch or traction is then applied to the muscles, and the bones either slip into position or are eased into place with pressure from the physician's hands. These techniques can be done in the emergency room or doctor's office. Sometimes, it is necessary to take the individual to the operating room for general anesthesia to obtain enough muscle relaxation to manipulate the bones into the correct position. Slings or braces are used to rest the joint after reduction. If the reduction is not maintained, surgery (open reduction) may be required to tighten or strengthen surrounding tissue. External fixation rarely is used to maintain the corrected position and instead an ORIF procedure, which is more commonly used for fracture fixation, may be employed.

Source: Medical Disability Advisor






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