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Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment

HCPCS code

Name of the Procedure:

Ankle Foot Orthosis, Posterior, Single Bar, Clasp Attachment to Shoe Counter, Prefabricated, Including Fitting and Adjustment (L1910). Common names: AFO, Posterior Ankle Foot Orthosis, Single Bar AFO.

Summary

This procedure involves fitting a prefabricated ankle-foot orthosis (AFO) that supports the foot and ankle. It is attached to the shoe via a clasp and is designed to assist with mobility by providing stability and alignment.

Purpose

The orthosis is used to treat conditions that affect foot and ankle stability, such as foot drop, neuromuscular disorders, and deformities. Its primary goal is to improve the patient's walking ability by providing necessary support and alignment.

Indications

  • Foot drop
  • Weakness in ankle muscles
  • Spasticity resulting in foot deformities
  • Post-surgical rehabilitation
  • Conditions like cerebral palsy, multiple sclerosis, or stroke.

Preparation

  • No specific fasting or medication adjustments typically required.
  • An initial consultation with a healthcare provider or orthotist for assessment.
  • Often involves an evaluation of the patient's lower limb function and gait analysis.

Procedure Description

  1. Initial Assessment: The patient’s specific condition and requirements are assessed.
  2. Selection: A prefabricated orthosis is chosen according to the patient's size and needs.
  3. Fitting: The orthosis is fitted to the patient's foot and ankle, ensuring proper alignment and stability.
  4. Adjustment: Necessary adjustments are made for comfort and effectiveness.
  5. Attachment: The orthosis is securely attached to the patient’s shoe using the clasp mechanism.

Tools/Equipment: Prefabricated AFO, fitting tools, measuring tape. Anesthesia/Sedation: None required.

Duration

The fitting and adjustment procedure typically takes about 30-60 minutes.

Setting

This procedure is usually performed in an outpatient clinic or an orthotic and prosthetic facility.

Personnel

  • Orthotist or Prosthetist
  • Occasionally, a Physical Therapist for functional assessment

Risks and Complications

  • Skin irritation or pressure sores from improper fit.
  • Discomfort due to lack of proper adjustment.
  • Rarely, worsening of pre-existing conditions due to improper use.

Benefits

  • Improved mobility and gait stability.
  • Reduced risk of falls and related injuries.
  • Enhanced overall quality of life. Benefits are usually realized immediately after fitting and adjustment, but full adaptation may take a few weeks.

Recovery

  • Post-procedure care involves regular check-ups to ensure proper fitting.
  • Patients may need to start gradually, wearing the orthosis for short periods and increasing over time.
  • Daily skin checks for irritation or pressure points.
  • Follow-up appointments for any necessary adjustments.

Alternatives

  • Custom-built AFOs.
  • Functional electrical stimulation devices.
  • Physical therapy for strengthening muscles. Pros and Cons:
  • Custom-built AFOs may offer a better fit but are more expensive.
  • Functional electrical stimulation can be effective but involves higher costs and more maintenance.

Patient Experience

Patients may experience initial discomfort and require an adaptation period. Pain management includes adjusting the orthosis for a better fit and using padding to alleviate pressure points. Comfort improves as the patient becomes accustomed to the device.

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