Name of the Procedure:

All Lower Extremity Prosthesis, Shank Foot System with Vertical Loading Pylon (L5987)

• Common Names: Prosthetic leg, artificial limb
• Medical Terms: Lower extremity prosthesis with vertical loading pylon

Summary

This procedure involves fitting a patient with a lower extremity prosthetic leg that includes a shank foot system, featuring a vertical loading pylon. The pylon enhances stability and mimics natural limb function by absorbing shock and reducing impact on the residual limb.

Purpose

The prosthesis is designed for individuals who have lost a lower limb due to trauma, disease, or congenital conditions. It aims to restore mobility and improve the quality of life by allowing patients to walk and engage in daily activities with greater ease and comfort.

Indications

• Amputation due to diabetes, peripheral vascular disease, or traumatic injury
• Congenital limb deficiencies
• Inadequate function of existing lower extremity prosthesis
• Improved gait stability and reduced pain or discomfort in the residual limb

Preparation

• Pre-procedure consultation and assessment by a prosthetist and possibly an orthopedist
• Measurements and molds of the residual limb
• Potential adjustments to current medications
• No fasting generally required

Procedure Description

1. Initial Consultation: The patient meets with the prosthetist for a thorough assessment.
2. Measurement and Fitting: Exact measurements and molds of the residual limb are taken.
3. Custom Fabrication: The prosthetic limb is custom-made to fit the patient's unique anatomy.
4. Trial and Adjustments: Initial fit trial is performed, and necessary adjustments are made.
5. Final Fitting: The prosthetic limb is fully assembled, typically including the vertical loading pylon, and fitted for long-term use.
6. Training: Patient undergoes gait training to learn how to use the new prosthesis effectively.

• Tools and Equipment: Measurement tools, casting materials, prosthetic components, vertical loading pylon, alignment devices
• Anesthesia or Sedation: Not typically required for fitting and adjustments

Duration

Fitting and adjustments can take several sessions over a few weeks, but individual appointments usually last 1-2 hours.

Setting

• Prosthetics clinic
• Outpatient rehabilitation center

Personnel

• Certified Prosthetist
• Rehabilitation Specialist
• Physical Therapist (for gait training)
• Occasionally an Orthopedic Surgeon (for clinical input)

Risks and Complications

• Skin irritation or sores on the residual limb
• Alignment issues causing discomfort or gait problems
• Device breakage or malfunction
• Psychological adjustment to the prosthesis

Benefits

• Improved mobility and independence
• Enhanced stability and comfort
• Better quality of life and ability to participate in daily activities
• Immediate benefits may be realized, though optimal use can take weeks of adjustment and training

Recovery

• Follow-up appointments for adjustments
• Regular skin checks and limb care
• Physical therapy sessions for gait training and strengthening
• Full functional adaptation within a few weeks to months, depending on individual progress

Alternatives

• Standard lower extremity prosthesis without vertical loading pylon
  • Pros: May be less complex and more affordable
  • Cons: Reduced shock absorption and stability
• Wheelchair for mobility
  • Pros: Non-invasive, no fitting required
  • Cons: Reduced mobility and independence compared to a prosthesis

Patient Experience

During fitting and adjustments, the patient may feel minor discomfort as the prosthetist ensures a perfect fit. Post-fitting, some initial discomfort or soreness is expected as the patient acclimates to the new device. Pain management is achieved through proper fitting and gradual adaptation, as well as support from the prosthetist and physical therapist.