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There is no dominant or preferred lower extremity. Most conditions of the lower extremity relative to the dominant side refer to the employability of the patient and determine disability, not physical impairment. Ankylosis Ankylosis is defined as absence of joint motion. Since no joint motion can be measured, ankylosis cannot be considered range of motion. Therefore ankylosis values are combined with all other values of the extremity. Since there can be many planes of movement of a joint, there can be multiple ankyloses. When multiple ankyloses occur in the same joint, the evaluator should utilize the largest value for impairment rating.
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Example:
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Wrist joint ankyloses at 20 degrees palmar flexion and 10 degrees ulnar deviation.
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20 degrees palmar flexion ankylosed = 47% upper-extremity impairment 10 degrees ulnar deviation anklyosed = 50% upper-extremity impairment
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SOLUTION:
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50% impairment for upper extremity (higher value).
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Example:
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Hip joint anidyoses at 20 degrees flexion and 10 degrees internal rotation
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20 degrees flexion ankylosed = 54% lower-extremity impairment10 degrees internal rotation anklyosed = 78% lower-extremity impairment
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SOLUTION:
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78% impairment for lower extremity (higher value).
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Additional Ratable Disorders of the Extremities Painful Organic Syndrome—A musculoskeletal condition characterized by pain with use of the affected member, which may or may not limit the voluntary active range of motion, with or without any limitation of passive range of motion, and attributed to a lesion in the soft tissues (capsule, ligament, tendon, fascia, muscle), and documented by clinical findings.
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Upper Extremity
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Shoulder
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3% U E
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Elbow
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3%UE
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Wrist/Hand
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3% U E
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Lower Extremity
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Hip
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4% L E
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Knee
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4%LE
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Ankle/Foot
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4% L E
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