Name of the Procedure:

Upper extremity addition, removable insert, each (L6691)

Summary

This procedure involves adding a removable insert to a prosthesis for an upper extremity (such as an arm or hand). The insert is customized to fit the patient’s prosthetic socket to enhance comfort and functionality.

Purpose

The removable insert addresses fit and comfort issues for users of upper extremity prostheses. The primary goals are to improve the fit of the prosthetic limb, enhance the user’s comfort, and increase the functionality and wear time of the prosthesis.

Indications

• Discomfort or pain from an ill-fitting prosthetic socket
• Skin irritation or pressure sores from the prosthesis
• Changes in limb volume or shape affecting the fit of the prosthesis
• Patients requiring improved prosthetic comfort and function

Preparation

• Patients typically need a preliminary assessment by a prosthetist.
• No specific preparation such as fasting or medication adjustments is required.
• Diagnostic tests like limb volume measurements may be taken.

Procedure Description

1. The prosthetist will first assess the fit of the current prosthesis.
2. Measurements of the residual limb are taken to create a customized insert.
3. The insert is fabricated from materials like silicone or foam.
4. The insert is then fitted into the prosthetic socket.
5. Adjustments are made to ensure optimal comfort and fit.

Duration

The procedure typically takes about 1-2 hours including assessment, measurements, and fitting.

Setting

This procedure is performed in an outpatient clinic or a specialized prosthetics office.

Personnel

• Certified Prosthetist
• Assistant Prosthetist (if necessary)

Risks and Complications

• Temporary discomfort as the patient adjusts to the new insert
• Potential for initial skin irritation
• Rare risk of insert causing undue pressure or misalignment

Benefits

• Improved comfort with the prosthetic limb
• Enhanced functionality and use of the prosthesis
• Better cushioning to prevent skin irritation and pressure sores

Recovery

• Patients can resume normal activities immediately after the fitting.
• Follow-up appointments are usually scheduled to ensure proper fit and make any necessary adjustments.

Alternatives

• Permanent alterations to the prosthetic socket
• Use of different prosthetic liners or cushions
• Each alternative has its pros and cons; for instance, a permanent alteration might offer a long-term solution but lacks the flexibility of a removable insert.

Patient Experience

• Patients may experience some initial discomfort as they adapt to the new insert.
• Most will notice a significant improvement in comfort and fit within a few days.
• Pain management is generally not needed, but over-the-counter pain relief can be used if necessary.
• Regular follow-ups ensure ongoing comfort and fit.