The first four editions of the AMA Guides use the same method to measure finger range of motion (ROM) and derive impairment percentages. This method is reliable and works well to rate finger joint injuries (e.g., fractures, sprains) that cause reduced finger joint ROM. This method, however, frequently underestimates the functional difficulty (impairment) caused by tendon injuries that restrict the excursion of tendons. For this reason, a second method to rate ROM in fingers (the TAM method) was introduced in the Fifth Edition.
For example, a patient had an extensor tendon laceration on the dorsum of his hand that was surgically repaired. When the motion in the involved middle finger is measured using the Guides traditional method (Figure 16-20, Neutral Position and Flexion of Finger DIP Joint; Figure 16-22, Neutral Position and Flexion of Finger PIP Joint; and...
