Foot, abduction rotation bar, without shoes
HCPCS code
Name of the Procedure:
Common Names: Foot Abduction Bar, Clubfoot Brace
Medical Term: Foot, Abduction Rotation Bar, Without Shoes (L3150)
Summary
The Foot Abduction Rotation Bar is a medical brace used to treat and maintain the correction of clubfoot deformity, typically following corrective surgery or casting. It helps in holding the feet in the correct position during the growth and development of the child.
Purpose
Medical Conditions: Congenital clubfoot, Metatarsus adductus
Goals/Outcomes: To maintain the corrected position of the feet, prevent relapse of foot deformity, and ensure proper foot and leg alignment during the child's growth.
Indications
Symptoms/Conditions: Clubfoot deformity, Post-surgical correction of clubfoot
Patient Criteria: Primarily infants and young children who have undergone clubfoot corrective treatment.
Preparation
Pre-Procedure Instructions: No specific preparation such as fasting is required. Parents might be instructed on how to fit and adjust the brace.
Diagnostic Tests: Typically follows corrective surgery or casting for clubfoot, so initial diagnostic imaging and assessments would have already been completed.
Procedure Description
Step-by-Step Explanation:
- The brace consists of shoes attached to a bar. The shoes are adjusted according to the child's foot position.
- The feet are placed into the shoes, and the bar is adjusted to ensure the correct degree of abduction (outward rotation).
- Parents are taught how to place and remove the brace properly to maintain the therapeutic effect.
Tools/Equipment: Abduction rotation bar with attached shoes
Anesthesia/Sedation: Not applicable
Duration
The fitting and adjustment of the brace usually take about 30 minutes. The duration of use can vary, often being worn full-time initially and then transitioning to night-time use over several years.
Setting
Typically performed in an outpatient clinic or orthopedic specialist’s office.
Personnel
Orthopedic specialists, Pediatricians, Orthotists, Nurses - mainly for fitting and adjustments.
Risks and Complications
Common Risks: Skin irritation, Blisters, Pressure sores
Rare Risks: Temporary discomfort, Non-compliance leading to recurrence of deformity
Management: Regular follow-up visits to monitor for complications, parental education on skin care and brace adjustment
Benefits
Expected Benefits: Maintains correction of clubfoot, Prevents relapse of deformity
Realization: Benefits are usually seen within weeks to months, with long-term use ensuring proper foot and leg development.
Recovery
Post-Procedure Care: Daily skin checks, Proper hygiene, Adjustments as the child grows
Recovery Time: Ongoing usage, with periodic assessments
Restrictions: No specific restrictions, but compliance with brace-wearing schedule is crucial
Follow-Up Appointments: Regular visits to monitor progress and make necessary adjustments.
Alternatives
Other Treatment Options: Serial casting (Ponseti method), Surgical intervention, Physical therapy
Pros and Cons:
- Serial Casting: Non-invasive but may require regular adjustments and re-casting.
- Surgery: More invasive but may be needed for complex cases.
- Physical Therapy: Supportive treatment but less effective alone for severe deformities.
Patient Experience
During the Procedure: Initial fitting may be uncomfortable for a short period as the child gets used to the brace.
After the Procedure: Possible mild discomfort or fussiness initially; skin checks and adjustments can minimize issues.
Pain Management: Generally no pain expected, but regular monitoring and timely adjustments help ensure comfort.