Name of the Procedure:

Addition to Lower Extremity, Symes Type, 'PTB' Brim Design Socket (L5632)

Summary

This procedure involves the addition or modification of a prosthetic socket to fit a lower extremity amputation stump. Specifically, it refers to customizing a 'PTB' (Patellar Tendon Bearing) brim design socket for a Symes type amputation, where the foot is removed but the heel pad is retained.

Purpose

• Medical Conditions: It addresses the need for a well-fitted prosthetic socket for patients with Symes type amputation.
• Goals: The aim is to provide a comfortable and functional fit for the prosthesis, enhancing mobility and reducing discomfort for the user.

Indications

• Symptoms/Conditions: Patients with an existing Symes type amputation needing improved prosthetic fit and comfort.
• Patient Criteria: This procedure is appropriate for those experiencing discomfort, skin issues, or suboptimal mobility due to a poorly fitting prosthetic socket.

Preparation

• Instructions: The patient may need to undergo a fitting session and allow for adjustments to their current prosthesis.
• Tests/Assessments: Measurements of the amputation stump and weight-bearing assessments will likely be performed.

Procedure Description

1. Measurement and Assessment: Initial measurements of the residual limb and examination of the existing prosthesis.
2. Design and Mold: Creating a custom mold or using CAD technology to design the PTB brim socket.
3. Material Selection: Choosing appropriate materials that offer durability and comfort.
4. Fabrication: Manufacturing the custom socket based on the design specifications.
5. Fitting and Adjustment: Ensuring the socket fits properly and making any necessary adjustments.
6. Final Check: Verifying comfort and functionality before finalizing the prosthesis.

Tools/Equipment:

• Measurement tools, casting materials, CAD software, prosthetic materials, and fitting tools.

Anesthesia: Not typically required for this procedure.

Duration

The entire process, from measurement to final fitting, may take several appointments over a few weeks.

Setting

This procedure is usually performed in a prosthetist’s office, outpatient clinic, or specialized prosthetic and orthotic facility.

Personnel

• Prosthetist: The main specialist responsible for the design and fitting.
• Orthopedic Technician: May assist in the preparation and fabrication.

Risks and Complications

• Common Risks: Minor discomfort during initial fittings.
• Rare Risks: Skin irritation, pressure sores.
• Management: Adjustments to the socket, use of protective liners.

Benefits

• Expected Benefits: Improved comfort, better mobility, and reduced skin issues.
• Realization: Benefits are typically noticed shortly after the final fitting.

Recovery

• Post-Procedure Care: Regular follow-up appointments to ensure proper fit and address any issues.
• Recovery Time: Immediate adjustment period with no significant downtime.
• Restrictions: Avoid high-impact activities until fully accustomed to the new socket.
• Follow-ups: Scheduled check-ins with the prosthetist.

Alternatives

• Other Options: Traditional sockets without PTB design, other types of prosthetic sockets.
• Pros/Cons: PTB design offers better weight distribution and comfort compared to traditional sockets which may not offer the same level of support.

Patient Experience

• During Procedure: Patients will undergo measurements and assessments; minimal pain involved.
• After Procedure: Initial adjustment period with possible soreness; pain management includes over-the-counter pain relief and fit adjustments.
• Comfort Measures: Use of cushioning liners and adjustment sessions to ensure the best possible fit.

By following these detailed guidelines, patients and healthcare providers can work together to achieve a successful outcome from the procedure.