QUESTION: My question relates to use of the AMA Guides, Fifth Edition, Table 17-33, Impairment Estimates for Certain Lower Extremity Impairments (5th ed, 546–547) in rating a 52-year-old man who sustained a comminuted, approximately 2-cm displaced intraarticular fracture of the distal tibia and fibula. A week later he underwent an open reduction and internal fixation (ORIF) during which the surgeon was able to achieve anatomic reduction of the fracture fragments, followed by casting, then physical therapy. When evaluated a year post-injury, the patient reported chronic swelling, worse after standing and sitting, and pain with ambulation. On examination, he had mild to moderate swelling compared to the opposite side, surgical scars, and mild tenderness over the fibula and medial malleolus. His examination was otherwise unremarkable, including normal gait, motion, and strength, with no atrophy?

Except for Table...

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