Name of the Procedure:

Elbow Orthosis, Double Upright with Forearm/Arm Cuffs, Free Motion, Custom Fabricated

• Common Names: Elbow Brace, Double Upright Elbow Support
• Technical/Medical Term: Custom Fabricated Elbow Orthosis (HCPCS Code: L3720)

Summary

An elbow orthosis is a type of brace designed to support and stabilize the elbow joint. The custom-fabricated double upright orthosis includes forearm and arm cuffs that allow free motion, providing the needed stabilization while permitting a range of movements helpful in daily activities.

Purpose

This custom-fabricated orthosis helps to manage and treat various elbow conditions by stabilizing the elbow joint, supporting injured tissues, and aiding in the healing process.

• Medical Conditions: Elbow injuries, post-surgical support, chronic elbow instability, arthritis.
• Goals/Outcomes: Reduce pain, prevent further injury, enhance recovery, and improve function and mobility in the affected elbow.

Indications

• Symptoms: Chronic elbow pain, weakness in the elbow, limited range of motion.
• Conditions: Ligament injuries, elbow dislocations, fractures, post-operative recovery, tendonitis, arthritis.
• Patient Criteria: Individuals needing custom support due to non-standard anatomy or specific medical conditions that standard braces cannot adequately address.

Preparation

• Instructions: Generally, no special preparation is required, but patients should follow any specific instructions from their healthcare provider.
• Pre-Procedure Assessments: A thorough evaluation by a healthcare professional, possibly including imaging studies like X-rays or MRIs, to determine the necessity and design of the orthosis.

Procedure Description

1. Assessment and Measurement: A healthcare provider will assess the elbow and take precise measurements.
2. Fabrication: The orthosis is custom-fabricated to these measurements, designed to fit the patient's arm and forearm accurately.
3. Fitting: Once fabricated, the orthosis is fitted and adjusted by a healthcare provider to ensure comfort and effectiveness.
4. Instruction: The patient is instructed on how to wear and care for the orthosis, as well as any do's and don'ts for using the brace.

• Tools/Equipment: Measurement tools, molds (if needed), materials for fabrication such as metal and padding.
• Anesthesia/Sedation: Not applicable.

Duration

The fitting and adjustment typically take about 30 minutes to an hour. The entire process, including fabrication, may take a few days to a couple of weeks depending on the facility.

Setting

Usually performed in an orthopedic clinic, a specialized brace shop, or as part of an outpatient service in a hospital.

Personnel

• Orthopedic Specialist: To assess and prescribe the orthosis.
• Orthotist: Specializes in the fabrication and fitting of custom orthoses.
• Healthcare Providers: Nurses or medical assistants may assist in the fitting process.

Risks and Complications

• Common Risks: Skin irritation, discomfort during initial wear.
• Rare Risks: Allergic reactions to materials, improper fit leading to nerve or vascular issues.
• Management: Adjustments to fit, switching materials, and providing skin protection can mitigate these risks.

Benefits

• Expected Benefits: Improved stability, pain reduction, enhanced functional use of the elbow joint.
• Timeline: Benefits can often be noticed immediately upon proper fitting, with ongoing improvements as the elbow heals.

Recovery

• Post-Procedure Care: Regular adjustment checks, proper cleaning and maintenance of the orthosis.
• Recovery Time: Varies by underlying condition and usage; follow healthcare provider recommendations.
• Restrictions/Follow-ups: Avoid activities that may stress the elbow unduly; follow schedule for check-ups and adjustments.

Alternatives

• Other Options: Standard off-the-shelf elbow braces, physical therapy, medication, surgical interventions.
• Comparison: Custom-fabricated orthoses offer a more precise fit and specific support compared to generic braces, though they take longer to obtain and can be more expensive.

Patient Experience

• During Procedure: No sedation or anesthesia, minimal discomfort during measurements and fitting.
• Post-Procedure: Initially, there might be slight discomfort as they adjust to the orthosis. Pain should decrease significantly as the elbow stabilizes. Comfort and ease of movement will typically improve over time.
• Pain Management: Over-the-counter pain relievers can be used if needed, based on the healthcare provider's advice.