Name of the Procedure:

Static Progressive Stretch Elbow Device
Medical Term: Static Progressive Stretch Elbow Orthosis (HCPCS Code: E1801)

Summary

A static progressive stretch elbow device is a medical tool used to help patients gradually regain their range of motion in the elbow. It’s typically adjustable and can be set to different extension and flexion settings, allowing progressive stretching of the joint over time.

Purpose

This procedure is commonly used to treat patients experiencing limited elbow mobility due to injury, surgery, or chronic conditions like arthritis. The goal is to improve joint flexibility, reduce stiffness, and enhance overall functional use of the arm.

Indications

• Patients with elbow stiffness and restricted range of motion.
• Post-operative recovery from elbow surgeries (e.g., tendon repair, fracture fixation).
• Chronic conditions causing joint contractures or flexion deformities.
• Trauma-induced elbow injuries requiring long-term rehabilitation.

Preparation

• Patients should wear comfortable, loose-fitting clothing to their appointment.
• No specific dietary restrictions or fasting required.
• Prescribed range of motion assessments and possibly imaging tests (X-rays, MRIs) for baseline measurements.

Procedure Description

1. Assessment and Customization: A healthcare provider evaluates the patient's elbow and customizes the device to fit their arm comfortably.
2. Application: The device is applied to the elbow, ensuring that padding is correctly placed to avoid pressure sores.
3. Adjustments: The range of motion is adjusted based on the patient's current level of flexibility, starting with a comfortable extension or flexion setting.
4. Instructions: Detailed instructions are given on how to wear the device, duration of use per day, and how to make gradual adjustments to increase the stretch over time.

Duration

The initial fitting and instruction session typically take about 30-45 minutes.

Setting

This procedure is usually performed in an outpatient setting, such as a physical therapy clinic or an orthopedic specialist's office.

Personnel

• Orthopedic specialist or physical therapist primarily involved.
• Trained medical assistant may assist in adjusting and fitting the device.

Risks and Complications

• Minor skin irritation or pressure sores.
• Discomfort or pain if the stretch is increased too quickly.
• Rare risk of exacerbating existing injuries if not used correctly.

Benefits

• Gradual improvement in elbow range of motion and flexibility.
• Reduced stiffness and discomfort in the joint.
• Enhanced functional ability to perform daily activities.
• Benefits are typically realized over weeks to months of consistent use.

Recovery

• Daily use as directed by the healthcare provider, typically starting with shorter durations and gradually increasing.
• Regular follow-up appointments to monitor progress and make device adjustments.
• Patients should follow specific instructions for wear time and device adjustments to minimize risks.

Alternatives

• Physical therapy focusing on manual stretching and exercises.
• Dynamic splinting, which offers continuous passive motion with adjustable resistance.
• Surgical intervention for severe contractures or adhesions.

Pros and Cons:

• Static progressive stretch devices are non-invasive and can be done at home, but may require diligent usage.
• Physical therapy offers personalized supervision but may involve more frequent visits.
• Surgery may provide quicker results for severe cases, but comes with higher risks and longer initial recovery.

Patient Experience

• Initially, patients may experience mild discomfort as the joint is stretched.
• Consistent use often leads to improved comfort and increased range of motion.
• Pain management through over-the-counter pain relievers and following the recommended adjustment schedule. Comfort measures may include using cushioning pads and ensuring proper device fit.

Overall, the static progressive stretch elbow device offers a structured and effective approach to regaining elbow mobility with minimal risk when used correctly and under professional guidance.