Name of the Procedure:

Common Name(s): Hand Orthosis for Metacarpal Fracture Technical/Medical Term: Hand orthosis, metacarpal fracture orthosis, prefabricated item customized for individual fit (HCPCS Code: L3917)

Summary

A hand orthosis for a metacarpal fracture is a prefabricated support used to stabilize and protect the bones in the hand after they have been fractured. It is customized through trimming, bending, molding, and assembling to ensure a perfect fit to the patient’s specific anatomy by a skilled professional.

Purpose

The orthosis is designed to immobilize the metacarpal bones to facilitate proper healing while allowing some degree of movement in adjacent joints. It helps to reduce pain, prevent further injury, and promote effective bone healing.

Indications

• Acute metacarpal fractures
• Post-surgical stabilization of the metacarpal region
• Pain or instability in the metacarpal bones due to injury
• Patients who require support but do not need a full cast

Preparation

• An evaluation by a healthcare professional, typically an orthopedic specialist or a physical therapist.
• Imaging tests such as X-rays to assess the fracture.
• No specific fasting or medication adjustments are generally required.

Procedure Description

1. Assessment: The patient undergoes a thorough assessment to determine the correct orthosis type.
2. Selection: A prefabricated orthosis is selected based on the size and requirements.
3. Customization: The orthosis is trimmed, bent, molded, and assembled to ensure it fits the patient's hand and fracture site perfectly.
4. Fitting: The customized orthosis is fitted onto the patient's hand, ensuring comfort and proper immobilization.
5. Instruction: The patient is instructed on how to wear, remove, and care for the orthosis.

Tools and Equipment:

• Prefabricated orthosis
• Cutting and molding tools
• Padding materials for extra comfort

Anesthesia or Sedation:

• Typically, no anesthesia or sedation is required.

Duration

The customization and fitting of the orthosis usually take about 30-60 minutes.

Setting

The procedure is typically performed in an outpatient orthopedic clinic or physical therapy center.

Personnel

• Orthopedic specialist or physical therapist
• Skilled technician to assist in customization
• Nursing staff for initial assessment and follow-up care

Risks and Complications

• Common risks include discomfort or skin irritation.
• Rare risks may involve improper fit leading to reduced healing efficacy or skin breakdown.
• Complications are generally minimal and manageable with proper adjustment and follow-up.

Benefits

• Immediate stabilization of the fractured area.
• Reduced pain and enhanced comfort.
• Improved healing outcomes due to proper immobilization.
• The patient can begin gentle movements to maintain joint flexibility.

Recovery

• Follow instructions for wear time and care.
• Generally no restrictions on daily activities apart from avoiding stress on the injured hand.
• Follow-up appointments to assess healing and adjust the orthosis as needed.
• Full recovery typically occurs within 6-8 weeks, but this can vary based on the nature of the fracture.

Alternatives

• Traditional plaster or fiberglass cast:
  • Pros: Often more rigid, complete immobilization.
  • Cons: Heavier, can be more restrictive, may require more follow-ups for adjustments.
• Surgical intervention:
  • Pros: Direct fixation of bones.
  • Cons: Invasive, longer recovery time, potential surgical risks.

Patient Experience

• During the procedure, patients may experience brief discomfort as the orthosis is adjusted.
• After fitting, patients typically report relief from pain due to the improved stabilization of their hand.
• Pain management typically involves over-the-counter pain medications if needed.
• Comfort measures include proper padding and ensuring a secure but comfortable fit.

By addressing the key aspects of the procedure, this markdown-styled guide aims to provide comprehensive information while being accessible to patients and healthcare providers alike.