Name of the Procedure:

Above Elbow, Molded Socket, Endoskeletal System, including Soft Prosthetic Tissue Shaping (HCPCS Code: L6500)
Common name(s): Above elbow prosthesis, Endoskeletal elbow prosthetic.

Summary

This procedure involves creating and fitting a custom prosthetic arm for individuals who have lost their arm above the elbow. The prosthesis features a molded socket that fits over the residual limb and an endoskeletal system for structural support. Soft prosthetic tissue shaping ensures comfort and a natural appearance.

Purpose

The procedure addresses limb loss above the elbow due to trauma, medical conditions, or congenital absence. The goal is to restore the function and appearance of the lost limb, enabling the patient to perform daily activities more independently.

Indications

• Amputation above the elbow due to trauma or injury
• Limb loss from medical conditions such as cancer or severe infection
• Congenital limb deficiencies
• Patient willingness and physical capacity to use a prosthesis

Preparation

• Pre-procedure consultation and assessment by a prosthetist and physician.
• Ensure the residual limb is properly healed before fitting.
• No specific fasting or medication adjustments required.

Procedure Description

1. Measurement and casting of the residual limb to create a custom-molded socket.
2. Design and fabrication of the endoskeletal structure, incorporating joints and connectors.
3. Soft prosthetic tissue shaping to match the patient's dimensions and skin tone.
4. Fitting the prosthetic device to the patient and making adjustments for comfort and function.
5. Training the patient on the use and care of the prosthesis.

Duration

The entire process, from initial assessment to final fitting, can take several weeks to months, with each appointment lasting from 1 to 3 hours.

Setting

The procedure is typically conducted in a specialized prosthetic clinic or rehabilitation center.

Personnel

• Prosthetist
• Rehabilitation specialist
• Sometimes an occupational therapist

Risks and Complications

• Skin irritation or sores from the socket
• Improper fit leading to discomfort or malfunction
• Infection risks if the residual limb is not properly cared for
• Adjustments may be needed over time

Benefits

• Improved functionality and ability to perform daily tasks
• Enhanced self-esteem and body image
• Increased independence

Recovery

• Initial adaptation period of several weeks as the patient learns to use the prosthetic.
• Regular follow-up appointments for adjustments and assessments.
• No major restrictions, but gradual increase in prosthetic usage is recommended.

Alternatives

• No prosthesis: maintaining function with assistive devices.
• Externally powered or myoelectric prosthesis: offers enhanced functionality but may be more complex and expensive.
• Cosmetic prosthesis: focuses on appearance rather than function.

Patient Experience

Patients may initially experience discomfort or difficulty using the prosthetic. Pain management techniques and persistent use will improve comfort and functionality. Regular follow-up and minor adjustments help ensure an optimal fit and experience.