Name of the Procedure:

Wrist Hand Orthosis (WHOs) with Non-Torsion Joint(s) Common name(s): Wrist Splint, Hand Brace Technical/medical term: Wrist-Hand Orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles; may include soft interface, straps, prefabricated item customized to fit a patient (HCPCS Code: L3915).

Summary

This procedure involves fitting a patient with a prefabricated wrist-hand orthosis (splint or brace) that has been customized to ensure a precise fit. The device includes one or more joints that do not twist, and it may include elastic bands, turnbuckles, and soft straps to provide stability and support to the wrist and hand.

Purpose

The wrist-hand orthosis is designed to:

• Alleviate pain and discomfort.
• Stabilize and support weakened or injured wrist and hand muscles and joints.
• Facilitate recovery from conditions affecting wrist and hand function.
• Improve overall hand functionality and dexterity.

Indications

This procedure is indicated for patients with:

• Carpal tunnel syndrome.
• Tendonitis or tendinopathy.
• Post-operative recovery from wrist or hand surgery.
• Fractures or sprains in the wrist or hand.
• Arthritis affecting the wrist and hand.

Preparation

Preparation for fitting a wrist-hand orthosis is typically minimal:

• Patients should bring any x-rays or diagnostic images for reference.
• No specific fasting or medication adjustments are required.

Procedure Description

1. Initial Assessment: The healthcare provider evaluates the patient's wrist and hand condition and measures the affected area.
2. Selection of Orthosis: A prefabricated orthosis suited for the patient's condition is selected.
3. Customization: The orthosis is trimmed, bent, molded, and assembled to precisely fit the patient's wrist and hand.
4. Fitting: The customized orthosis is fitted onto the patient, ensuring that it provides the necessary support and does not cause discomfort.
5. Adjustment: Additional adjustments are made to ensure optimal comfort and functionality.
6. Instruction: The patient is given instructions on how to wear, adjust, and care for the orthosis.

Tools and equipment used include measuring tapes, cutting tools, heating elements (for molding), and various fastening components.

Duration

The fitting and customization process typically takes about 30 to 60 minutes.

Setting

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

Personnel

Involved healthcare professionals include:

• Orthopedic specialist or clinician.
• Medical fitter or orthotist.
• Occasionally, a nurse for additional assistance.

Risks and Complications

• Possible skin irritation or pressure sores if the orthosis is not fitted properly.
• Temporary discomfort during the initial adjustment period.
• Rarely, allergic reactions to the material used.

Benefits

• Immediate support and stabilization of the wrist and hand.
• Relief from pain and discomfort.
• Improved hand function and mobility.
• Reduced risk of further injury.

Recovery

• Patients may need to wear the orthosis for several weeks or months, depending on their condition.
• Instructions on daily wear, hygiene care, and any activity restrictions will be provided.
• Follow-up appointments may be necessary for adjustments.

Alternatives

Other treatment options include:

• Physical therapy.
• Medications (anti-inflammatory drugs, pain relievers).
• Alternative types of wrist braces or splints.
• Surgical intervention for severe conditions. Each alternative has its respective pros and cons, such as duration of therapy, cost, and invasiveness.

Patient Experience

During the procedure, the patient may experience:

• Mild discomfort during fitting and adjustment. After the procedure:
• Initial adjustment discomfort wearing the orthosis.
• Noticeable improvement in wrist and hand stability and reduction in pain. Pain management and comfort measures include prescribing pain relievers if needed and advising on proper orthosis care and adjustment.