Lower limb injury
Hip injury after a motor accident
A hip claim may involve fracture, dislocation, labral or tendon injury, cartilage loss or persistent movement restriction. Part 6 requires the most specific valid lower-limb method rather than defaulting to pain or gait.
Motor accident injury
How can this injury happen?
Car or passenger collision
Dashboard loading, side intrusion or seat-belt force can injure the femoral head, acetabulum, labrum or surrounding tendons.
Motorcycle accident
A rider landing on the hip may sustain femoral neck, acetabular or pelvic fracture and soft tissue injury.
Pedestrian or cyclist impact
Direct impact can cause fracture, dislocation or labral and muscle injury, often with associated pelvic trauma.
Injuries that can occur
- femoral neck, head or intertrochanteric fracture
- hip dislocation or acetabular injury
- labral or cartilage injury
- gluteal or iliopsoas tendon injury
- post-traumatic arthritis or avascular necrosis
Symptoms and functional problems
- groin, lateral hip or buttock pain
- difficulty walking, stairs, transfers or prolonged sitting
- restricted flexion, rotation or abduction
- clicking, catching or reduced weight-bearing tolerance
Seek urgent medical assessment
Inability to weight-bear, deformity, major shortening or suspected hip fracture/dislocation requires urgent assessment.
Clinical evidence
What findings matter?
The assessor should identify fracture, joint, labral, tendon or arthritis pathology and then select the most specific valid method. Gait is a last resort, not a substitute for hip evidence.
| Record or examination | What it may establish | What it cannot prove alone |
|---|---|---|
| X-ray, CT or MRI | Shows fracture, dislocation, cartilage, labral pathology, arthritis or avascular necrosis. | Imaging alone does not set WPI or prove causation. |
| Active hip ROM | Measures flexion, extension, abduction, adduction and rotation. | Only reliable active measurements are used. |
| Weight-bearing and clinical examination | Records gait, leg length, tenderness, stability and functional restrictions. | Painful walking does not justify gait derangement if a more specific method applies. |
Movement in daily life
How movement affects real activities
Hip flexion helps sitting and climbing stairs; extension supports walking; abduction and adduction move the leg sideways; rotation assists turning, dressing and getting in or out of a vehicle.
Flexion and extension
Sitting, rising, stairs, walking and getting into a car.
AMA4 Table 40 addresses active hip motion under clauses 6.84-6.85.
Abduction and adduction
Side-stepping, transfers and balance.
Only the most severe deficit from the same applicable motion table is rated as clause 6.85 directs.
Internal and external rotation
Turning, dressing, putting on shoes and pivoting.
Active rotation must be measured reliably, not inferred from pain.
Threshold injury is a separate question: hip soft tissue strain may be threshold. Fracture, nerve injury or verified partial/complete tendon, ligament or cartilage rupture may be non-threshold.
Part 6 permanent impairment
How is CTP WPI assessed?
Clauses 6.68-6.75 require the most specific method. Potential hip methods include ROM, ankylosis, arthritis based on joint-space radiology and a diagnosis-based estimate under Table 64.
Measurement rules that apply
- Clauses 6.69 and 6.70 require the method that most specifically addresses the lower-limb impairment. Gait should not replace a joint, nerve, fracture or replacement method that can be applied reliably.
- Clause 6.84 requires active range of motion, a goniometer where clinically indicated and consistent repetitions when reliability is uncertain. Passive movement may inform the examination but does not set the impairment value.
- Clause 6.85 says only the most severe deficit in one direction or axis from the same lower-limb ROM table is rated. Deficits from separate tables may be combined only as the Guidelines permit.
| Method | CTP source | When it is relevant | Important limit |
|---|---|---|---|
| Hip ROM | Clauses 6.84-6.85; AMA4 Table 40 | Permanent reliable active motion loss. | Do not add multiple deficits from the same motion table. |
| Hip arthritis | Clauses 6.88-6.92; Table 62 | Properly positioned radiographs showing cartilage interval. | Osteophytes, cysts and pain are not the measurement. |
| Diagnosis-based estimate | Clauses 6.94-6.97; Table 64 | A listed residual diagnosis with required signs and footnotes. | Exact row criteria must be checked in readable AMA4. |
- Calculate lower-extremity impairment first, then convert with Table 6.4.
- If equally specific valid methods exist, clause 6.70 permits the method giving the higher rating.
- Assess a separate pelvic or nerve injury under its own method.
What cannot be combined?
- gait derangement with any other lower-limb evaluation
- arthritis with gait, atrophy, strength or ROM under clause 6.91
- two methods rating the same hip consequence
What does not establish WPI by itself?
- hip pain
- labral signal on MRI
- osteophytes without cartilage interval
- limp where a specific method applies
Motor accident examples
Side impact with acetabular and hip injury
The acetabular component may use Table 64 while a separate pelvic fracture follows clause 6.154; double counting must be avoided.
Persistent hip stiffness without structural row
Reliable active Table 40 movement may be the more specific method than gait.
Claim file preparation
Evidence checklist
Assessment source
Hip WPI assessment source
Assessment source: Motor Accident Guidelines v10.1 clauses 6.68-6.75, 6.84-6.102; AMA4 Tables 40, 46-50, 62, 64 and Table 6.4.
Threshold injury: Hip strain may be threshold; fracture, nerve injury or verified rupture may be non-threshold. WPI is separate.
What the assessor checks
- most specific method rule
- active hip ROM
- arthritis radiology
- diagnosis-based method
- Table 6.4 conversion
What does not establish the result by itself
- pain
- MRI label
- osteophytes
- limp
Official sources
Related NSW CTP guides
Free claim check
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Frequently asked questions
- Is hip WPI based on pain?
- No. It uses a permitted method such as active ROM, properly measured arthritis or a valid diagnosis-based estimate.
- Can a labral tear be rated from MRI?
- Not from imaging alone. Residual signs, function, causation and the applicable method are required.
- Can gait be used?
- Only as a last resort when no more specific valid method applies.
- How is hip arthritis measured?
- Clauses 6.88-6.90 use the articular cartilage interval on properly performed radiographs, not osteophytes or pain.
- How is lower-limb impairment converted?
- The selected lower-extremity value is converted to WPI using Table 6.4.