Fingers are the bones located at the end of the hand, and are referred to as digits, or phalanges. The ring finger is the third finger of the hand. Amputation is the removal of a limb, appendage, or outgrowth of the body. In this case, the amputation refers to amputation of the ring finger.

Amputations usually stem from disabilities of the musculoskeletal system due to damage from trauma, peripheral vascular disease, tumor, infection, or congenital anomaly.

Functional loss may manifest from absence of part, or all, of the necessary bones, joints and muscles, or associated structures. Prior to an amputation of the ring finger, manifestations may include: pain; tenderness; weakness; paleness; cyanosis; numbness; stiffness; decreased sensation; ulcers; deformities; swelling; or paralysis. After the amputation, there may be pain, blood loss, deformity, possible infection, and shock.

Examinations used to evaluate functional loss from an amputation, or the need for the procedure would most likely include: physical examinations focused on evaluation of the patient's musculoskeletal system for swelling, deformity, tenderness, range of motion and circulation; x-rays to visualize bone loss; laboratory tests to determine underlying cause and possible complications; and goniometers to measure joint movements and angles. Computed tomography (CT) scan, and magnetic resonance imaging (MRI) are not commonly used, but may assist in visualizing areas that cannot be seen by regular x-ray.

In case of traumatic amputation, surgery may be indicated. After healing of an amputation site, regardless of cause, a prosthesis is usually applied. Special care to the residual part is needed. Postoperatively, specific treatment of the stump is essential for a prosthesis to fit properly, and to assist the patient to regain mobility. To prevent contractures, range of motion exercises and proper alignment are encouraged.

• Phantom limb pain occurs in 70% of new amputees. Contractures can occur if conditioning exercises are not done. Finally, due to body image disturbances, patients may require emotional support and counseling.

• When deciding expressly claimed issues, decision makers must consider entitlement to any complications that are within the scope of the claim, including those identified by the rating criteria for that condition in 38 CFR Part 4. This could include but is not limited to, scars as the result of surgical intervention for a service-connected (SC) disability.

• The rating schedule for musculoskeletal was updated on February 7, 2021. Protection still does apply and should be considered with existing evaluations (38 CFR 3.951(a)).

• Do not use numerical designations for either the fingers or the joints of the fingers. Each digit, except the thumb, includes three phalanges:

  • the proximal phalanx (closest to the wrist)

  • the middle phalanx, and

  • the distal phalanx (closest to the tip of the finger).

•  If the location of the injury in the hand is unclear, obtain x-rays to clarify the exact point of injury. 

• Determining dominant handedness – See 38 CFR 4.69.

• The single finger amputation ratings are the only applicable ratings for amputations of whole or part of single fingers.

• Plate III – SINGLE FINGER AMPUTATIONS