Name of the Procedure:

Upper Extremity Addition, Frame Type Socket, Below Elbow or Wrist Disarticulation (HCPCS Code: L6687)

• Common Names: Prosthetic Socket Addition, Below-Elbow Frame Socket
• Technical/Medical Terms: Upper extremity prosthesis frame addition, below elbow disarticulation socket

Summary

This procedure involves adding a frame-type socket to an upper extremity prosthetic designed for patients who have undergone below elbow or wrist disarticulation. The frame-type socket provides a more secure and comfortable attachment for the prosthetic limb, enhancing its functionality.

Purpose

The procedure is designed to improve the fit and function of a prosthetic limb for amputees. It aims to provide better stability, comfort, and mobility, allowing the patient to perform daily activities with greater ease.

Indications

• Patients with below-elbow or wrist disarticulation amputations.
• Those experiencing discomfort or instability with their current prosthetic socket.
• Individuals seeking improved prosthetic limb function and attachment.

Preparation

• No special fasting or medication adjustments are typically required.
• Pre-procedure assessments may include measurements and fitting sessions with a prosthetist to ensure a custom fit.

Procedure Description

1. Assessment and Measurement: The prosthetist assesses the residual limb and takes detailed measurements to customize the frame-type socket.
2. Socket Fabrication: Using the measurements, a frame-type socket is crafted, typically from durable materials like carbon fiber or thermoplastic.
3. Fitting Session: The patient attends a fitting session where adjustments are made to ensure optimal comfort and function.
4. Final Attachment: The customized socket is attached to the existing prosthetic limb, and further adjustments are made as necessary.

Tools & Equipment:

• Measurement tools
• Prosthetic components
• Materials for socket fabrication (carbon fiber, thermoplastic)

Anesthesia or Sedation:

• Typically, no anesthesia or sedation is required for this procedure.

Duration

The entire process of assessment, socket fabrication, and fitting may take several weeks, but individual fitting sessions usually last around 1-2 hours.

Setting

• Prosthetics clinic
• Outpatient healthcare facilities

Personnel

• Prosthetist
• Occupational therapist (optional for training and adjustment)

Risks and Complications

• Common Risks: Minor discomfort during fitting, initial adjustment period.
• Rare Risks: Skin irritation, pressure sores, poor fit leading to suboptimal prosthetic function.

Benefits

• Improved prosthetic fit and comfort
• Enhanced stability and control of the prosthetic limb
• Increased ability to perform daily activities

Recovery

• Immediate use post-procedure, with an adjustment period of a few days to weeks.
• Follow-up appointments for adjustments and to address any issues.
• Regular skin checks to prevent irritation or sores.

Alternatives

• Alternative Sockets: Traditional suction or vacuum-assisted sockets.
• Pros and Cons:
  • Traditional Suction: May be uncomfortable for some users, but widely available.
  • Vacuum-Assisted: Offers good stability but can be more expensive and require maintenance.

Patient Experience

During the fitting sessions, patients may experience minor discomfort or pressure. After the socket is attached, patients should gradually adapt to the prosthesis with improved comfort and function. Pain management is typically minimal, involving over-the-counter pain relief if necessary.