Name of the Procedure:

Addition to Lower Extremity Orthosis, Drop Lock Retainer
Common names: Drop Lock Addition, Orthotic Locking Mechanism Addition
Technical terms: Addition to Lower Extremity Orthosis, Drop Lock Retainer (L2785)

Summary

This procedure involves the addition of a drop lock retainer to a lower extremity orthosis (leg brace). A drop lock is a locking mechanism that secures the joint of the orthosis in a fixed position to enhance stability.

Purpose

This procedure addresses issues related to instability in the lower limbs, such as knee buckling or hyperextension. The goal is to improve mobility and safety by providing additional support and stability to the affected leg during movement.

Indications

• Chronic knee instability
• Neurological conditions causing leg weakness (e.g., cerebral palsy, stroke)
• Post-surgical rehabilitation where joint stability is needed
• Progressive conditions like multiple sclerosis affecting leg strength

Preparation

• No specific fasting or medication adjustments are usually required.
• Assessment by an orthotist to determine suitability and measurement for the orthosis.
• Physical examination and possibly imaging studies to evaluate the underlying cause of instability.

Procedure Description

1. Assessment and Planning:
   • An orthotist evaluates the patient's needs and measures for the orthosis.
2. Fabrication:
   
   • The orthosis is custom-fabricated based on the patient's measurements.
3. Addition of Drop Lock Retainer:
   • The drop lock mechanism is precisely installed at the knee joint of the orthosis.
4. Fitting and Adjustment:
   • The patient tries on the orthosis, and adjustments are made for comfort and function.
5. Instruction and Training:
   • The patient is taught how to use the orthosis and engage/disengage the lock.

Tools: Measuring tape, fabricating materials, lock mechanism components, wrench/screwdriver.

Duration

The fitting and addition procedure typically takes about 1-2 hours.

Setting

• Orthotic clinic or outpatient center specializing in assistive devices.

Personnel

• Certified Orthotist
• Occupational therapist (for training on use)
• Occasionally a physical therapist

Risks and Complications

• Common Risks: Skin irritation, initial discomfort.
• Rare Risks: Poor fit leading to ineffective support, mechanical failure of the lock.

Possible Complications: Skin sores from friction, incorrect locking that affects movement, all typically manageable with adjustments.

Benefits

• Enhanced stability and safety when walking or standing.
• Potentially improved confidence and independence in mobility.
• Benefits are often realized immediately upon proper fitting and adjustment.

Recovery

• No recovery period per se, but there is an adjustment period where the patient gets accustomed to the orthosis.
• Follow-up appointments typically one week post-fitting and then as needed.
• Maintenance care for the orthosis as instructed by the orthotist.

Alternatives

• Physical Therapy: Strengthening exercises without orthosis.
• Other Orthoses: Different design orthosis or braces.

• Surgical Interventions: In cases where orthotic solutions are insufficient.

  Each alternative has its pros and cons, with physical therapy potentially requiring longer durations to achieve similar stabilization.

Patient Experience

• May feel unusual or uncomfortable initially, similar to wearing new footwear.
• Potential for mild to moderate pain if adjustments are needed, managed with over-the-counter pain relief.

• Comfortable and natural walking experience expected soon after proper adjustment.

  Pain management: Primarily includes adjustments for comfort and occasional use of mild pain relievers.