Name of the Procedure:

Common Name: Lower Extremity Prosthetic Socket Insert Technical Term: Addition to Lower Extremity, Below Knee/Above Knee, Custom Fabricated from Existing Mold or Prefabricated, Socket Insert, Silicone Gel, Elastomeric or Equal, for Use with Locking Mechanism (HCPCS Code: L5673)

Summary

This procedure involves fitting a custom or prefabricated silicone gel or elastomeric socket insert into the prosthetic socket of a below-knee or above-knee lower extremity prosthesis. The insert enhances comfort and security by using a locking mechanism to keep the prosthesis securely attached.

Purpose

Medical Conditions: This procedure addresses limb loss due to conditions like trauma, diabetes, vascular disease, or congenital limb differences. Goals: The aim is to improve prosthetic fit, comfort, reduced pressure points, and overall patient mobility and quality of life.

Indications

Symptoms/Conditions: A patient with a below-knee or above-knee amputation requiring a more secure and comfortable fit of their prosthetic limb. Patient Criteria: Individuals who experience discomfort, skin irritation, or instability with their current prosthetic socket.

Preparation

1. Pre-procedure Instructions:
   • No special fasting or medication adjustments are typically required.
2. Diagnostic Tests/Assessments:
   • Detailed measurements of the residual limb.
   • Examination of existing prosthetic components.

Procedure Description

1. Step-by-Step:
   • The residual limb is measured and possibly cast to create an exact mold.
   • The custom or prefabricated insert is crafted and fitted into the existing prosthetic socket.
   • The insert is adjusted to ensure a snug fit and aligned with the locking mechanism.
2. Tools/Equipment: Prosthetic measurements tools, molding materials, silicone gel or elastomeric insert, locking mechanism components.
3. Anesthesia/Sedation: Typically, no anesthesia or sedation is required.

Duration

The fitting process usually takes about 1-2 hours in total, depending on the complexity of custom fabrication or adjustments required.

Setting

The procedure is performed in an outpatient setting, such as a prosthetic clinic or specialized orthopedic center.

Personnel

Involved Professionals:

• Certified prosthetist
• Prosthetic technician

Risks and Complications

Common Risks:

• Minor skin irritation or pressure sores Rare Risks:
• Infections
• Allergic reactions to the materials used Management: Regular follow-up appointments to monitor and manage any issues.

Benefits

Expected Benefits:

• Enhanced comfort and fit of the prosthetic limb.
• Improved mobility and stability.
• Reduced skin irritation and pressure sores. Realization Time: Benefits can be observed almost immediately after proper fitting.

Recovery

Post-Procedure Care:

• Regular cleaning and maintenance of the prosthetic socket insert.
• Monitoring for any skin issues. Expected Recovery Time: Minimal recovery time; normal activities can generally be resumed immediately. Restrictions: Follow-up visits may be necessary for adjustments.

Alternatives

Other Options:

• Standard prosthetic socket liners without locking mechanisms.
• Alternatives like different materials or suspension systems. Pros and Cons:
• Standard liners may be less costly but may not offer the same comfort and security.
• Alternative suspension systems might provide similar stabilization but can vary in comfort and ease of use.

Patient Experience

During Procedure: The patient may experience some pressure during fitting and alignment but generally no pain. After Procedure: Patients may need an adjustment period to get used to the new socket insert; pain management can usually be handled with over-the-counter pain relief if needed. Comfort measures include regular prosthetic checks and adjustments to ensure optimal fit and function.