Name of the Procedure:

Upper Extremity Fracture Orthosis, Humeral, Prefabricated

Common name(s): Humeral fracture brace, Sling and Swathe, Shoulder Immobilizer
Technical/medical term: Upper Extremity Fracture Orthosis, Humeral, Prefabricated (HCPCS Code L3980)

Summary

This procedure involves fitting and adjusting a prefabricated orthosis (brace) designed to immobilize the humerus (the bone of the upper arm) following a fracture. The brace supports the healing process by keeping the bone in a stable position.

Purpose

Medical Conditions or Problems Addressed

• Humeral fractures, post-operative immobilization, humeral stress fractures.

Goals or Expected Outcomes

• Stabilize the broken bone to promote proper healing.
• Reduce pain and swelling.
• Prevent further injury.

Indications

Symptoms or Conditions

• Recent humeral fracture.
• Post-operative stabilization following humeral surgery.
• Chronic conditions affecting the humerus that may require immobilization for healing.

Patient Criteria

• Patients of all ages with a diagnosed humeral fracture.
• Patients needing immobilization of the upper arm for medical reasons.

Preparation

Pre-Procedure Instructions

• No specific fasting or medication adjustments needed.
• Ensure clothing is loose-fitting to accommodate the orthosis.

Diagnostic Tests or Assessments

• X-rays or other imaging tests to confirm the fracture and its specifics.
• Medical history review.

Procedure Description

1. Assessment: The healthcare provider will examine the injured area and review imaging results.
2. Selection: A prefabricated orthosis of the appropriate size will be chosen.
3. Fitting: The orthosis is applied to the affected arm.
4. Adjustment: Straps and fasteners are adjusted to ensure proper fit, stability, and comfort.
5. Instruction: Patient and/or caregiver are educated on how to put on, take off, and maintain the brace.

Tools and Equipment

• Prefabricated humeral orthosis.
• Straps, fasteners, and padding.

Anesthesia or Sedation

• Not typically required.

Duration

• The fitting and adjustment process usually takes 20-30 minutes.

Setting

• Outpatient clinic, orthopedic office, or emergency department.

Personnel

• Orthopedic specialist, nurse, or trained medical technician.

Risks and Complications

Common Risks

• Temporary discomfort.
• Skin irritation or pressure sores.

Rare Risks

• Improper immobilization leading to poor bone healing.
• Circulatory problems if applied too tightly.

Management

• Regular follow-up to monitor fit and healing.
• Adjustments to the orthosis as needed.

Benefits

• Enhanced stabilization and alignment of the fractured bone.
• Reduced pain and swelling.
• Facilitated proper healing and quicker return to normal function.

Recovery

Post-Procedure Care

• Keep the orthosis clean and dry.
• Regularly inspect the skin under the brace for signs of irritation.
• Follow prescribed physical therapy or exercise routines.

Recovery Time

• Typically, six weeks to three months, depending on the severity of the fracture.

Restrictions and Follow-Up

• Limited use of the affected arm.
• Regular follow-up appointments for X-rays and adjustments to the orthosis.

Alternatives

Other Treatment Options

• Surgical fixation with plates and screws.
• Use of a custom-made orthosis.

Pros and Cons of Alternatives

• Surgical fixation may offer quicker stabilization but comes with surgical risks.
• Custom-made orthoses can offer a better fit but are usually more expensive and take longer to have made.

Patient Experience

During Procedure

• Patients may feel mild discomfort as the brace is applied and adjusted.
• Minimal pain, typically no anesthesia needed.

After Procedure

• Some discomfort or irritation as they get used to wearing the brace.
• Pain relief is usually managed with over-the-counter pain medications.
• Gradual improvement in pain and ability to move the arm as healing progresses.