5223.0130 Musculoskeletal Schedule; Wrist


Published: 2015

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5223.0130 MUSCULOSKELETAL SCHEDULE; WRIST.


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Subpart 1.

General.

Permanent partial disability of wrist is disability of the whole body as set in subparts 2 and 3.


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Subp. 2.

Range of motion.


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A.

Excision distal end of ulna, flexion and extension credited with 75 percent of hand, and rotation 25 percent of hand, 5 percent;


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B.

Total ankylosis in optimum position, 19 percent;


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C.

Total ankylosis in malposition of extreme flexion or extension, 25 percent;


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D.

Limitation of motion:

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(1)

mild, rotation normal, loss of 15 degrees palmar flexion and loss of 20 degrees dorsiflexion, 5 percent;


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(2)

moderate, rotation limited to 60 degrees in pronation-supination, loss of 25 degrees palmar flexion, loss of 30 degrees dorsiflexion, 10 percent; or


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(3)

severe, rotation limited to 30 degrees in pronation-supination, palmer flexion less than 25 degrees, dorsiflexion less than 30 degrees, 15 percent.




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Subp. 3.

Procedure or conditions.


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A.

Colles/Smith, extra-articular:

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(1)

no loss of motion, 0 percent;


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(2)

mild loss of motion as defined in subpart 2, item D, subitem (1), 3 percent.



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B.

Colles/Smith/Barton, intra-articula:

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(1)

no loss of motion, 0 percent;


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(2)

mild loss of motion as defined in subpart 2, item D, subitem (1), 6 percent;


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(3)

moderate loss of motion as defined in subpart 2, item D, subitem (2), 10 percent.



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C.

Carpal bone fracture, no loss of motion, 3 percent.


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D.

Carpal dislocation, mild loss of motion as defined in subpart 2, item D, subitem (1), 6 percent.


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E.

Carpal tunnel release, 0.5 percent.


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F.

Carpal tunnel release with moderate paresthesias, 3 percent.


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G.

DeQuervain's release, 0 percent.


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H.

Ganglion excision, 0 percent.


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I.

Scaphoid graft, 3 percent.