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.

Traction


Specialists

  • Neurologist
  • Neurosurgeon
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist (Physical Medicine and Rehabilitation Specialist)
  • Physical Therapist
  • Rheumatologist

Comorbid Conditions

  • Circulatory disorders (e.g., varicose veins)
  • Osteomyelitis
  • Skin conditions

Factors Influencing Duration

The length of disability depends on whether the traction is an intermittent therapy used at home or in a physical therapy office or if it is part of long-term treatment in a hospital setting.

Medical Codes

ICD-9-CM:
93.41 - Spinal Traction Using Skull Device; Traction Using: Caliper Tongs, Crutchfield Tongs, Halo Device, Vinke Tongs
93.42 - Spinal Traction, Other
93.43 - Skeletal Traction, Intermittent
93.44 - Skeletal Traction, Other; Bryants Traction; Dunlops Traction; Lyman Smith Traction; Russells Traction
93.45 - Thomas Splint Traction
93.46 - Skin Traction of Limbs, Other; Adhesive Tape Traction; Boot Traction; Bucks Traction; Gallows Traction

Overview

Traction is the force used to pull on a body part (or parts) to stretch or separate. The force can be applied to the skin, skeleton, head, or trunk and transmits the pull to the bone and muscles. Traction can be used for short or long term treatment.

Traction is usually applied to the spine, pelvis, neck, arms, or legs. The force is generated by weight or force against the weight of the body. The two main types of traction are skin traction and skeletal traction. Of these two types, many specialized forms have been developed to treat conditions in specific parts of the body. With skin traction, weights are attached to the skin, which applies the pulling force to the bone. It is used when light (5 to 7 lb; 2 to 3 kg) or short-term traction is needed. With skeletal traction, pins are attached to the bone so that the pulling force is applied directly to the bone. Skeletal traction is used when skin traction is not possible and when greater weight (25 to 40 lb; 11 to 18 kg) is needed.

Traction is used to treat broken bones (fractures), joint dislocations, and long-term muscle spasms by keeping the muscles stretched. It is a common, effective treatment especially in injuries sustained during high-energy traumas such as motor vehicle accidents and falls.

Use of traction has changed in recent history. For example, it used to be the standard treatment for fractures of the thighbone (femur). The need for prolonged hospitalization, frequent traction adjustments, high-risk of incorrect fracture union (malunion), and the development of complications associated with long-term bed rest has made surgery a more desirable treatment for femoral fracture than traction. However, traction is a viable treatment option for individuals not medically stable for surgery or whose femur is broken into many small pieces (comminuted).

Source: Medical Disability Advisor



Reason for Procedure

Traction relaxes muscle tension and spasm, repositions fracture fragments (reduces a fracture), maintains alignment of bones, maintains length of bones during healing, allows joint motion during fracture healing, reduces swelling, and facilitates joint relocation by reducing muscle spasm.

Source: Medical Disability Advisor



How Procedure is Performed

Skin traction uses noninvasive means in attaching weights to the skin to apply a pulling force to the underlying bone. Depending on where traction is needed, weights are attached with tape, straps, boots, or cuffs. Skin traction on the fingers may use the weight of the arm hanging by the fingers as the traction force without any added weights. Traction is applied to the trunk with a waist belt attached to ropes and pulleys and is actually a form of skin traction.

Skeletal traction requires insertion of pins or wires into the bone either during open surgery or pierced through the skin. The pins are then rigged to weights by ropes and pulleys. Traction to the head applies a pulling force to the neck and can be accomplished with a neck halter hooked to a rope and pulley system or by tongs inserted directly into the skull that are then hooked onto a rope and pulley system.

Inversion traction (a form of skeletal traction) places the individual in a partially upside down position. Fixation devices apply a gentle, steady force to encourage bone lengthening in a procedure called an Ilizarov limb lengthening. The Ilizarov technique involves the application of skeletal traction to two different sites in the same bone. The bone is then cut in the middle and gradually separated (distracted) through an attached external frame. This technique is usually used to lengthen long bones. These devices can also be used to maintain fracture alignment while allowing joint motion.

Traction equipment needs to hang from a bed frame or over a doorframe usually by means of a pulley. It can be used temporarily (e.g., during surgery to maintain body position) or applied for weeks at a time as in a neck fracture. Short periods of manual traction are used during reduction of fractures and dislocations where the physician or assistant manually applies the traction force against the weight of the individual.

Source: Medical Disability Advisor



Prognosis

Outcome depends on the reason for traction. Traction usually produces very good results. In most cases, traction can successfully realign the ends of a fractured bone and maintain proper bone length, relieve pain, end muscle spasm, relax muscles, and reduce a dislocated joint.

Source: Medical Disability Advisor



Complications

The main complications with skin traction occur when the traction is applied incorrectly. If traction wrappings are too tight, the nerves and blood vessels can be impaired. Traction wrappings around bony prominences can cause skin pressure sores (lesions). Skin straps may slip resulting in skin injury. Infection can occur around the pins or wires used for skeletal traction. Bone inflammation can occur as a response to a foreign material introduced in the body (skeletal traction). Excessive joint separation (overdistraction) can occur if the traction weight is too great. Overdistraction can cause nerve damage. Prolonged bed rest associated with long-term traction can lead to blood clots (deep vein thrombosis), bedsores, lung compromise, and urinary tract infections. Inversion traction can cause heartburn (reflux), headaches, overstretching of facet joints (hyperextension), and a ruptured aneurysm of the cerebral artery (berry aneurysm). Long-term traction can have a negative emotional effect on the individual. Traction can also cause joint stiffness.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Individuals are not able to work while using traction devices. Upon returning to work, restrictions and accommodations are related to the specific injury or condition for which traction was required.

Source: Medical Disability Advisor



References

General

Wieting, J. Michael. "Massage, Traction, and Manipulation." eMedicine. Eds. Robert J. Kaplan, et al. Medscape. 22 May 2005 <http://emedicine.com/pmr/topic200.htm>.

Source: Medical Disability Advisor






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