Name of the Procedure:

Addition to Lower Extremity Fracture Orthosis, Plastic Shoe Insert with Ankle Joints.

• Common Name: Orthotic Shoe Insert with Hinged Ankles
• Medical Term: L2180 Procedure

Summary

This procedure involves adding a custom plastic insert with ankle joints to a lower extremity fracture orthosis. It is designed to improve stability, mobility, and overall support during the healing process of lower extremity fractures.

Purpose

This orthotic device addresses lower extremity fractures to:

• Provide additional support and stability to the injured limb.
• Facilitate proper alignment and healing.
• Enhance mobility while protecting the fracture site.
• Reduce pain and improve functional outcomes during recovery.

Indications

• Patients with fractures in the lower extremity (foot, ankle, lower leg).
• Individuals needing enhanced stability and support for impaired joints.
• Those who have difficulty with standard orthosis due to stability issues.

Preparation

• No specific fasting is required.
• Patients must provide their medical history, including current medications.
• A physical examination and potentially imaging tests (X-rays) to assess the fracture and fit for the orthosis.
• Patients may need to wear appropriate footwear during fitting.

Procedure Description

1. Assessment and Measurement: The patient's lower extremity is assessed, and measurements are taken to create a custom-fit plastic shoe insert.
2. Preparation of Orthosis: The plastic shoe insert with adjustable ankle joints is prepared based on the measurements.
3. Fitting and Adjustment: The insert is added to the existing fracture orthosis, ensuring it aligns correctly with the patient's foot and ankle.
4. Testing and Instruction: The patient tries on the orthosis, and adjustments are made for comfort and effectiveness. Instructions on how to use and care for the orthosis are provided.

Tools: Measurement tools, custom plastic insert, ankle joints, existing orthosis. No anesthesia or sedation is required.

Duration

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

Setting

This procedure is usually performed in an orthopedic clinic or outpatient facility.

Personnel

• Orthotist (orthotic specialist)
• Orthopedic technician or nurse

Risks and Complications

• Common Risks: Discomfort or pressure sores if the insert is not properly adjusted.
• Rare Risks: Allergic reaction to the materials used.
• Management: Adjustments to fit and material, periodic reassessment to ensure proper alignment and comfort.

Benefits

• Enhanced stability and support for the healing limb.
• Improved mobility and reduced pain during the recovery process.
• Customization ensures precise fit and effectiveness.

Recovery

• Immediate post-procedure care involves monitoring comfort and fit.
• Patients can typically bear weight on the affected limb with support right away.
• Follow-up appointments to adjust the orthosis as the injury heals.
• Gradual return to normal activities as advised by the healthcare provider.

Alternatives

• Standard, non-custom orthotic devices.
• Casts or braces without additional support.
• Physical therapy and pain management. Pros: Cost-effective, commonly available. Cons: Less customized, potentially less effective in providing required stability and support.

Patient Experience

Patients may initially experience mild discomfort as they adjust to the new insert. Over-the-counter pain relievers and adjustments by the orthotist can help manage any discomfort. The insert ultimately aims to provide better mobility and reduced pain, enhancing overall patient comfort during the healing process.