Name of the Procedure:

Addition to Lower Extremity, Test Socket, Symes (L5618)

• Common Name: Test Socket Addition, Symes Level
• Medical Term: Prosthetic Test Socket Addition for Symes Amputation

Summary

The procedure involves the addition of a test socket to a lower extremity prosthesis, specifically for a Symes amputation. A test socket is a temporary, clear prosthetic used to ensure proper fit before the final prosthesis is created.

Purpose

This procedure addresses fit and comfort issues in lower extremity prostheses for patients who have had a Symes amputation, where the ankle joint is removed, and the heel pad is preserved. The goal is to achieve a precise fit for the final prosthesis, improving mobility and comfort.

Indications

• Patients with a recent Symes amputation.
• Individuals experiencing discomfort or improper fit with their current prosthetic.
• Patients undergoing adjustments or fittings for a new prosthetic limb.

Preparation

• No specific pre-procedure fasting or medication adjustments are required.
• Basic diagnostic assessments, such as limb measurements and skin condition evaluations, may be performed.

Procedure Description

1. Initial Assessment: The prosthetist evaluates the residual limb for any changes in volume or condition.
2. Casting: A cast of the residual limb is made to ensure a perfect fit.
3. Creating the Test Socket: The cast is used to create a clear, temporary socket.
4. Fitting and Testing: The test socket is fitted to the patient's limb and adjustments are made for optimal comfort and alignment.
5. Feedback: The patient provides feedback on the fit and any discomfort during walking or other activities.

Tools and Equipment: Casting materials, clear plastic for the test socket, tools for adjustments. Anesthesia/Sedation: Not applicable; the procedure is non-invasive.

Duration

The procedure typically takes between 1 to 2 hours, depending on the number of adjustments needed.

Setting

This procedure is usually performed in an outpatient prosthetics clinic.

Personnel

• Certified Prosthetist
• Prosthetic Technician
• Support staff, as needed

Risks and Complications

• Minor skin irritation or pressure sores from the test socket.
• Temporary discomfort during the fitting process.
• Rarely, allergic reactions to materials used.

Benefits

• Improved fit of the final prosthesis.
• Enhanced comfort and mobility.

• Immediate feedback allows for adjustments, leading to a better final product.

  Benefits are usually realized immediately during the fitting process and finalized once the definitive prosthesis is made.

Recovery

• Minimal recovery time; patients can resume normal activities immediately after the fitting.
• Follow-up appointments may be necessary for further adjustments.

Alternatives

• Direct fitting of the final prosthesis without a test socket may be quicker but carries a higher risk of improper fit.
• Using a prefabricated socket; however, this often does not achieve the same level of customization and comfort.

Patient Experience

• Patients may feel some mild discomfort during initial fittings, which usually resolves quickly with adjustments.
• The process is largely non-invasive and involves minimal physical strain.
• Prosthetists will work with patients to manage discomfort and ensure the best possible fit.