explosive effect of high velocity missile, residuals of debridement, or prolonged infection No single factor is controlling for the assignment of a disability Important: evaluation for a muscle injury. The entire evidence picture must be taken into consideration. For more information on assigning disability evaluations for Reference: muscle injuries, see , 20 Vet.App. 317 (2006) , 5 Vet.App. 70 (1993) , 18 Vet.App. 248 (2004), and . e. Fractures All fractures associated with a GSW and/or shell fragment wound (SFW) will Associated be considered open because all of them involve an opening to the outside. With Most GSW/SFW fractures are also comminuted due to the shattering nature GSW/SFW of the injury. f. Determining applies to certain combinations of muscle injuries and joint conditions. Whether 38 Consider the provisions of if CFR 4.55 Applies to are multiple MGs involved Muscle Injuries the MG acts on a joint or joints, and/or there is peripheral nerve damage to the same body part affected by the muscle. If more than one MG is injured or affected or if the injured MG acts on a g. Applying 38 CFR 4.55 to joint, conduct a preliminary review of the evidence to gather information Muscle Injuries needed to properly apply the provisions of . The information needed will include whether the affected MGs are in the same or different anatomic regions whether the MGs are acting on a single joint or multiple joints, and whether the or joints is/are ankylosed. After the preliminary review is complete, use the evidence gathered and apply the following table to determine how affects the evaluation of the muscle injury. Step Action 1 Does the MG(s) act on an ankylosed joint?
explosive effect of high velocity missile, residuals of debridement, or prolonged infection Important: No single factor is controlling for the assignment of a disability evaluation for a muscle injury. The entire evidence picture must be taken into consideration. Reference: For more information on assigning disability evaluations for muscle injuries, see , 20 Vet.App. 317 (2006) , 5 Vet.App. 70 (1993) , 18 Vet.App. 248 (2004), and . e. Fractures Associated With GSW/SFW All fractures associated with a GSW and/or shell fragment wound (SFW) will be considered open because all of them involve an opening to the outside. Most GSW/SFW fractures are also comminuted due to the shattering nature of the injury. f. Determining Whether 38 CFR 4.55 Applies to Muscle Injuries applies to certain combinations of muscle injuries and joint conditions. Consider the provisions of if are multiple MGs involved the MG acts on a joint or joints, and/or there is peripheral nerve damage to the same body part affected by the muscle. g. Applying 38 CFR 4.55 to Muscle Injuries If more than one MG is injured or affected or if the injured MG acts on a joint, conduct a preliminary review of the evidence to gather information needed to properly apply the provisions of . The information needed will include whether the affected MGs are in the same or different anatomic regions whether the MGs are acting on a single joint or multiple joints, and whether the or joints is/are ankylosed. After the preliminary review is complete, use the evidence gathered and apply the following table to determine how affects the evaluation of the muscle injury. Step Action 1 Does the MG(s) act on an ankylosed joint?
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