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5227
§ 4.71a Schedule of ratings—musculoskeletal system.

Ring or little finger stiffness or immobility (ankylosis)

The ring or little finger is stiff or locked in place, limiting its ability to move.

What the rating means

Diagnostic code 5227 covers ankylosis of the ring or little finger — meaning one or both of those fingers are locked and cannot move through a normal range. VA rates this condition at 0% for both unfavorable and favorable ankylosis, whether the affected hand is your major (dominant) or minor (nondominant) hand.

Even though the rating is 0%, VA is required to consider two additional things. First, VA must determine whether evaluating the finger as an amputation would produce a higher rating. Second, VA must consider whether the stiffness restricts movement in your other fingers or interferes with how your hand works as a whole, and whether a separate evaluation for those effects is warranted. Those additional considerations can change the overall picture even when the ankylosis itself rates at 0%.

Whether ankylosis is unfavorable or favorable depends on joint position and how close your fingertip comes to your palm when you try to flex it. A gap of more than two inches between the fingertip and the proximal transverse crease of the palm is unfavorable; two inches or less is favorable.

Evidence that helps

Because the rating under this code is 0% regardless of whether ankylosis is favorable or unfavorable, the most useful evidence focuses on the two additional considerations VA must make: whether amputation criteria apply and whether other fingers or overall hand function are affected.

Medical records and physical examination findings should document which joints are locked (metacarpophalangeal, proximal interphalangeal, or both), the exact position of each ankylosed joint, and the measured gap between the fingertip and the proximal transverse crease of the palm when you try to flex the finger. If both joints are ankylosed, the records should note any extension, full flexion, rotation, or angulation, because those findings trigger evaluation as an amputation.

Range-of-motion measurements for your other fingers on the same hand matter if the ankylosis restricts their movement. Statements from you or people who know you describing difficulty gripping, pinching, or performing tasks at work or at home can help show interference with overall hand function, which supports a separate evaluation at a higher level.

Secondary conditions

Conditions that are often caused or made worse by this one. If you have any of these, they may be claimable as secondary service connection.