Removed Prosthesis

N

NavyFC

PEB Forum Regular Member
Registered Member
Hey everyone,

My doctor just dictated a PEB, and waiting for the fit/unfit referral to IDES or not to come back. I was wondering something about my situation though. I had a radial head replacement done, then the prosthetic was causing me more harm than good, it seemed, based on pain. They recommended removing the prosthetic. I now have about a 1 inch gap instead of anything at the top of my radius. For the purposes of PEB and if it goes to it a disability rating, will I be treated as though I still have a prosthetic? There's not a whole lot in what I've found about a resection, only about replacements. Any advice?

Thanks in advance, this website/forum is an awesome resource for information.
 
No, it won't be treated as a current prosthesis if you don't have one. I would want to know more about the anatomical situation, but here are some codes that might fit (the first rating is for dominant hand, the second for non-dominant:

5209 Elbow, other impairment of Flail joint....................................................... 60......... 50
Joint fracture, with marked cubitus varus or cubitus valgus
deformity or with ununited fracture of head of radius..................... 20......... 20

5210 Radius and ulna, nonunion of, with flail false joint............................... 50......... 40
 
I'll provide as much more anatomical information as I can off the top of my head. There has been some "arthritic changes" as the doctor calls them, and a bit of HO around the area (I can get a copy of my most recent x-ray uploaded in a couple of days if you're interested). The head area of the radius has shifted a bit from where it should be (lined up against the capitellum) to the center of my arm, so it is directly above my ulna (even in full supenation). This is a result of a fracture dislocation (Mason type IV I think), non combat related, just from a bad fall during PT. I also broke the coronoid process of the ulna, but that seems to have healed ok. The doctor called the injury the terrible triad (dislocation, radial head, coronoid process). It is in my dominant arm. My current ROM is 30-125, due to the HO and arthritic changes. I've never been measured for the limits of pain free, but I do have more pain free motion in the very center of the arc since the implant was removed. I have been able to, though it has been extremely painful, regain "functional" strength in the sense that my arm is stronger now but less strong than my non-dominant side. I still don't use the right arm much outside of physical therapy because of the pain, I'm just vain enough to grit my teeth through 30 minutes of excruciating 2-3 days a week so that I can look somewhat normal. Other things normal, fit 28yo male in good shape (I still run).

As far as the rest of the pain management I'm on tramadol 50mg 1-2 every 6 hours, and naproxyn 500mg twice daily. This usually is enough to cover the day to day pain but some days it doesn't do a bit of good. The doctor asked me if the tramadol was still ok, and I said yes because I don't want to go to anything stronger and run the risk of addiction. But I digress...

Thanks for the information. I am not sure about "flail false joint"? What does that mean?

Thanks for your help, Jason.

Nick
 
Also, just for clarity, under 5209 I would be rated just under the 20 for the non-union of radius, correct? Or would it be 60 as a primary and an additional 20?
 
You would get the higher of the two, not both.
 
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