Fracture or avulsion or bony defect

Fracture:  The RMA defines "fracture" to mean an acquired break or rupture in a bone.

Avulsion:  Generally refers to a tearing away (or pulling off) such as with a traumatic amputation.

An avulsion fracture is a bone fracture which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma.  This can occur at the ligament due to the application forces external to the body (such as a fall or pull) or at the tendon due to a muscular contraction that is stronger than the forces holding the bone together.  This type of fracture is more prevalent in highly trained athletes.

If the fracture is small, it is usually sufficient to treat with ice, rest and support bandage, but in more severe cases surgery and fixation or pinning may be required.

Bony defect:  Is any abnormality to the bone, but is usually represented by additional or missing bone structure.  It can be caused by congenital malformations, such as with a cleft palate, or due to joints not healing properly or not being aligned properly following fracture or from surgical procedures such as a hip replacement, or knee reconstruction.

General Information

For a fracture, or avulsion, or bony defect to contribute to dislocation or joint instability, it must have involved (at least one of) the articulating surfaces of the affected joint.

Last reviewed for CCPS 16 June 2014.

Investigative Documents

Preliminary questions [42122]

42123 there is some evidence that a fracture or avulsion or bony defect involving the articulating surfaces may be a factor in the development or worsening of the joint instability.

42124 the veteran had a fracture or avulsion or bony defect involving the articulating surfaces at side and site of the body at some time.

42125 the veteran had the fracture or avulsion or bony defect involving the articulating surfaces to side and site of the body due to an illness or injury which is identifiable.

42126  the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and VEA service for joint instability.

42127 as a consequence of the identified illness or injury, the veteran had the fracture or avulsion or bony defect involving the articulating surfaces, to the side and site of the body, at the time of the clinical onset of joint instability.

42128   the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and VEA service for the clinical onset of joint instability.

42131  the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and operational service for the clinical onset of joint instability.

or

42132  the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and eligible service for the clinical onset of joint instability.

or

7334     the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.

7335     the condition under consideration permanently worsened.

42129 as a consequence of the identified illness or injury, the veteran had the fracture or avulsion or bony defect involving the articulating surfaces, to the side and site of the body, at the time of the clinical worsening of joint instability.

42130   the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and VEA service for the clinical worsening of joint instability.

42133  the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and operational service for the clinical worsening of joint instability.

or

42134  the veteran has established the causal connection between the fracture or avulsion or bony defect involving the articulating surfaces and eligible service for the clinical worsening of joint instability.

Clinical onset and operational service [42131]

42135  the identified illness or injury, which caused the fracture or avulsion or bony defect involving the articulating surfaces affecting side and site of the body, is causally related to operational service.

Clinical onset and eligible service [42132]

42136  the identified illness or injury, which caused the fracture or avulsion or bony defect involving the articulating surfaces affecting side and site of the body, is causally related to eligible service.

Clinical worsening and operational service [42133]

42135  the identified illness or injury, which caused the fracture or avulsion or bony defect involving the articulating surfaces affecting side and site of the body, is causally related to operational service.

42137 the clinical onset of the joint instability occurred prior to that part of operational service to which the identified illness or injury, as a consequence of which the veteran had the fracture or avulsion or bony defect involving the articulating surfaces to the side and site of the body, is causally related.

Clinical worsening and eligible service [42134]

42136  the identified illness or injury, which caused the fracture or avulsion or bony defect involving the articulating surfaces affecting side and site of the body, is causally related to eligible service.

42138 the clinical onset of the joint instability occurred prior to that part of eligible service to which the identified illness or injury, as a consequence of which the veteran had the fracture or avulsion or bony defect involving the articulating surfaces to the side and site of the body, is causally related.