Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment
HCPCS code
Name of the Procedure:
Common Name(s): KAFO, Femoral Fracture Cast Orthosis
Technical Term: Soft, Prefabricated KAFO, including fitting and adjustment (HCPCS Code L2132)
Summary
A KAFO (Knee-Ankle-Foot Orthosis) is a supportive device used to stabilize and facilitate the healing of femoral fractures. This particular version is soft, prefabricated, and includes personalized fitting and adjustments to ensure optimal comfort and effectiveness.
Purpose
Medical Conditions:
- Femoral fractures
- Instability due to muscle weakness or paralysis
- Post-surgical immobilization
Goals:
- Stabilize the femur to promote healing
- Reduce pain
- Allow functional mobility
Indications
Symptoms/Conditions:
- Acute or chronic femoral fractures
- Instability or weakness in the knee, ankle, or foot
- Post-operative stabilization needs
Patient Criteria:
- Patients with femoral fractures needing support
- Individuals requiring immobilization of the leg to aid healing
- Those who can benefit from a prefabricated, adjustable orthosis
Preparation
Pre-Procedure Instructions:
- Ensure the limb is clean and dry
- No fasting or medication adjustments typically required
Diagnostic Tests:
- X-rays to assess the fracture
- Physical examination to determine fitting requirements
Procedure Description
- Initial Assessment: Healthcare provider assesses the affected limb and takes necessary measurements.
- Fitting: The prefabricated soft KAFO is selected based on the patient’s measurements.
- Adjustment: The device is adjusted to fit snugly yet comfortably, ensuring proper alignment and support.
- Instruction: The patient is educated on how to wear, adjust, and care for the orthosis.
Tools and Equipment:
- Prefabricated soft KAFO
- Measuring tape and fitting tools
Anesthesia: Not required for this procedure.
Duration
The fitting and adjustment typically take about 30 to 45 minutes.
Setting
Can be performed in:
- Orthopedic clinic
- Outpatient rehabilitation center
- Hospital orthotics department
Personnel
Involved Healthcare Professionals:
- Orthotist (primary specialist fitting the KAFO)
- Orthopedic surgeon (if needed)
- Physical therapist (for mobility training, if applicable)
- Nurse (for initial assessment and follow-up)
Risks and Complications
Common Risks:
- Skin irritation
- Discomfort
- Improper fit leading to inadequate support
Rare Complications:
- Pressure sores
- Allergic reactions to materials
Management: Regular follow-ups for adjustments and monitoring of skin condition.
Benefits
Expected Benefits:
- Enhanced stability and protection for the femur
- Pain reduction
- Accelerated healing process
Timeframe: Benefits are typically realized soon after proper fitting, often within a few days.
Recovery
Post-Procedure Care:
- Regular cleaning of the orthosis
- Daily skin inspection to avoid irritation and pressure sores
Recovery Time: Varies based on the severity of the fracture and overall health, but typically several weeks to a few months.
Restrictions/Follow-Up:
- Limited weight-bearing as advised by the healthcare provider
- Regular follow-up appointments for adjustments and assessment
Alternatives
Other Treatment Options:
- Custom-made KAFO
- Rigid cast orthosis
- Surgical internal fixation
Comparisons:
- Custom devices offer precise fit but are more expensive and time-consuming.
- Rigid casts offer higher immobilization but less flexibility.
- Surgical options are invasive but may offer a quicker recovery for some fractures.
Patient Experience
During Procedure:
- Minimal discomfort during fitting
- Possible mild pressure sensations
After Procedure:
- Initial adjustment period with possible mild discomfort
- Pain management typically not required, but OTC pain relief can be used if needed.
The experience includes learning to gradually adapt to the orthosis, with the goal of significantly enhancing mobility and comfort as healing progresses.