Name of the Procedure:

Ankle Foot Orthosis, Fracture Orthosis, Tibial Fracture Orthosis, Soft, Prefabricated, Includes Fitting and Adjustment (HCPCS Code: L2112) Common names: AFO, Soft Tibial Fracture Brace

Summary

An Ankle Foot Orthosis (AFO) is a medical device designed to support and immobilize the ankle and foot, specifically used for tibial fractures. This prefabricated, soft orthosis provides necessary stabilization following a fracture and includes professional fitting and adjustment to ensure optimal comfort and efficacy.

Purpose

This orthosis is used to treat tibial fractures, helping to stabilize and immobilize the lower leg to promote proper healing. The goal is to reduce pain, prevent further injury, and support the healing process by keeping the bone in the correct position.

Indications

• Acute tibial fractures
• Post-operative support following tibial surgery
• Mild to moderate lower leg and ankle instability
• Conditions requiring immobilization and support of the tibia

Preparation

• No special fasting or medication adjustments are typically required.
• A thorough evaluation and measurement of the affected limb by a healthcare professional to ensure a proper fit.
• Possible imaging, such as X-rays, to assess the extent of the fracture and alignment.

Procedure Description

1. Assessment: Patient's leg is examined and measured to select the appropriate orthosis size.
2. Fitting: The prefabricated soft orthosis is applied to the patient's leg, ensuring it covers from below the knee down to the foot.
3. Adjustment: Straps and closures are adjusted to achieve a snug yet comfortable fit.
4. Instruction: Patient receives guidance on how to wear, remove, and care for the orthosis, including any restrictions on movement.

Duration

The fitting and adjustment process typically takes about 30 to 45 minutes.

Setting

The procedure is performed in an outpatient clinic, orthopedic office, or medical supply store.

Personnel

• Orthopedic specialists or trained orthotists
• Nurses or medical assistants may assist in the fitting process

Risks and Complications

• Skin irritation or pressure sores from prolonged use
• Discomfort due to improper fit
• Potential for delayed healing if the orthosis is not worn correctly
• Rarely, allergic reactions to materials used in the orthosis

Benefits

• Promotes proper healing of tibial fractures
• Reduces pain and discomfort associated with tibial fractures
• Improves mobility while providing necessary support
• Non-invasive and can cancel the need for surgery in certain cases

Recovery

• Patients are instructed on wearing schedules, typically advised to wear the orthosis during waking hours and potentially during sleep initially.
• Follow-up appointments are necessary to monitor healing progress and adjust the orthosis as needed.
• Recovery time varies depending on the severity of the fracture but generally lasts from several weeks to a few months.

Alternatives

• Rigid casts or splints, which can provide more immobilization but are less comfortable.
• Surgical intervention and internal fixation for more severe fractures.
• Pros: Alternatives like casts provide more rigid immobilization. Cons: Less comfort and limited mobility compared to the prefabricated soft orthosis.

Patient Experience

Patients may experience a period of adjustment to the orthosis, including initial discomfort or unfamiliarity. Soft padding and proper adjustments help manage pain and increase comfort. Pain management strategies and comfort measures include using padding and adhering to guidance on proper wear and maintenance of the orthosis.