Name of the Procedure:

Upper extremity addition, harness, (e.g., figure of eight type), single cable design (HCPCS Code: L6675)

Summary

This procedure involves the fitting of a harness designed for the upper extremity, often known as a "figure of eight" type, which incorporates a single cable design. This specialized medical device helps improve functionality and support for patients with upper extremity impairments.

Purpose

The procedure addresses conditions like shoulder dislocations, clavicle fractures, and paralysis or weakness in the upper extremities. The primary goals are to stabilize the affected area, improve mobility, and reduce discomfort.

Indications

• Persistent shoulder instability
• Subacute or chronic clavicle fractures
• Partial or complete paralysis of the upper arm
• Patients requiring upper arm support for rehabilitation

Preparation

• Follow specific instructions from the healthcare provider, which may include restrictions on arm movement.
• Diagnostic assessments such as X-rays or MRIs to identify the extent of injury or impairment.
• Discuss any current medications to avoid contraindications.

Procedure Description

1. The healthcare provider will carefully evaluate the patient's condition and take measurements for fitting.
2. The harness is applied around both shoulders, forming a "figure of eight" configuration.
3. Adjustments are made to ensure a snug but comfortable fit.
4. The single cable is positioned to optimize functionality and support.
5. Any final adjustments are completed to ensure the harness supports the anticipated movements and reduces strain.

Tools and Equipment Used:

• Specialized figure-of-eight harness
• Single cable mechanism
• Measuring tape and adjustment tools

Duration

The fitting process typically takes about 30-45 minutes.

Setting

This procedure is usually performed in an outpatient clinic or a rehabilitation center.

Personnel

• Orthopedic specialist or prosthetist
• Trained nurses or medical assistants

Risks and Complications

• Skin irritation or chafing at contact points
• Discomfort due to improper fitting
• Risk of decreased circulation if the harness is too tight
• Possible allergic reactions to materials used

Benefits

• Improved stability and functionality of the upper extremity
• Enhanced comfort and reduced dislocations or aggravation of injuries
• Faster rehabilitation process and improved quality of life

Recovery

• Patients are advised to engage in light activities initially and gradually increase intensity as per the doctor's advice.
• Follow-up appointments to adjust the harness for optimal comfort and functionality.
• Instructions on how to maintain and clean the harness.

Alternatives

• Conventional slings or braces
• Physical therapy without a harness
• Surgical intervention in severe cases

Pros and Cons:

• Harness provides immediate support and assistance in mobility, unlike exercises that need time for improvement.
• Surgery might offer a permanent solution but comes with higher risks and longer recovery times compared to using a harness.

Patient Experience

During the fitting, patients might feel slight discomfort when adjustments are made but generally experience relief once the harness is properly fitted. Post-fitting, instructions will be given to ensure maximum comfort. Pain management may involve over-the-counter pain relievers if needed.