Name of the Procedure:

Addition to Lower Extremity, Extended Steel Shank (HCPCS Code L2360)

Summary

The procedure involves adding an extended steel shank to prosthetic or orthotic devices for the lower extremity. This shank provides additional support and stability to the prosthesis, enhancing its functionality and durability, particularly for patients requiring extra reinforcement due to high activity levels or structural needs.

Purpose

This procedure is primarily used to address issues of insufficient support in lower extremity prosthetics. The goal is to strengthen the prosthetic device, thus ensuring better alignment and distribution of forces during walking or other activities. This leads to improved mobility, comfort, and overall quality of life for users.

Indications

• Patients with high activity levels that lead to increased wear and tear on their prosthetic devices.
• Individuals requiring additional structural support due to body weight or specific medical conditions affecting the lower extremities.
• Complaints of instability or discomfort with current prosthetic device.
• Professional recommendation based on gait analysis or other biomechanical assessments.

Preparation

• Pre-procedure consultation to assess the specific needs of the patient and the current state of the prosthesis.
• Potential diagnostic tests such as gait analysis or alignment assessments.
• Patients are generally required to bring their existing prosthetic device for fitting and adjustment.

Procedure Description

1. Assessment: Detailed examination of the existing prosthetic device and the patient's lower extremity.
2. Customization: Measurement and customization of the extended steel shank to fit the patient's prosthesis accurately.
3. Installation: The extended steel shank is attached to the prosthetic device. This may involve mechanical adjustments and fine-tuning.
4. Testing: The prosthesis is tested on the patient to ensure proper fit and function.
5. Adjustment: Final adjustments are made based on patient feedback and functional testing.

Tools used typically include measuring instruments, alignment tools, and specialty wrenches or screwdrivers. The procedure does not usually require anesthesia or sedation.

Duration

The procedure typically takes between 1 to 2 hours, including assessment, customization, fitting, and adjustments.

Setting

The procedure is usually conducted in an outpatient clinic specializing in prosthetics and orthotics.

Personnel

• Orthotist/Prosthetist
• Support staff such as prosthetic technicians

Risks and Complications

• Minor risks include discomfort during initial fittings and adjustments.
• Rare risks might include improper alignment leading to temporary gait issues.
• Complications can be managed with further adjustments and follow-up visits.

Benefits

• Improved stability and functionality of the prosthetic device.
• Enhanced patient mobility and comfort.
• Reduction in wear and tear, thereby increasing the longevity of the prosthesis.
• Benefits are usually realized immediately after the adjustment, but optimal comfort might be achieved after a few days of usage.

Recovery

• No significant recovery time is required.
• Patients may resume normal activities immediately, though they should monitor for any discomfort or issues.
• Follow-up appointments may be scheduled to ensure the prosthesis is functioning correctly.

Alternatives

• Use of different materials or design modifications for the prosthesis.
• Regular replacements or upgrades to the prosthetic device.
• Pros and cons: Alternatives may offer varying levels of support and longevity, with some being less robust than the extended steel shank option.

Patient Experience

• Patients might experience slight discomfort during the adjustment phase.
• Adaptation period where patients get accustomed to the new feel of the prosthesis.
• Pain management is generally not required, but comfort measures are prioritized during fitting and adjustments.