Name of the Procedure:

Addition to Upper Extremity Prosthesis, Below Elbow/Above Elbow, Custom Fabricated from Existing Mold or Prefabricated, Socket Insert, Silicone Gel, Elastomeric or Equal, for Use with Locking Mechanism (L6694)

Common name(s): Socket Insert Addition for Prosthesis
Technical term: HCPCS Code L6694

Summary

This procedure involves adding a custom-made or prefabricated socket insert made from silicone gel, elastomeric material, or a similar substance, to an existing upper extremity prosthesis for the below elbow or above elbow. The insert is designed to improve the comfort and fit of the prosthesis and is used in conjunction with a locking mechanism.

Purpose

The procedure addresses issues of discomfort, poor fit, and instability in patients using upper extremity prostheses. The goal is to enhance comfort, improve the fit of the prosthesis, and ensure better functionality for the user.

Indications

• Patients experiencing discomfort or pain with their current prosthetic socket.
• Those with issues of instability or improper fit of the prosthetic limb.
• Patients requiring an improved locking mechanism for better prosthetic control.
• Individuals with upper limb amputations who use a prosthesis.

Preparation

• Patients should inform their healthcare provider of any allergies or medical conditions.
• No special fasting or significant medication adjustments typically required.
• Assessment of the existing prosthesis and fit evaluation by a prosthetist.

Procedure Description

1. Assessment and Mold Creation: The prosthetist assesses the current fit of the existing prosthesis. A mold of the socket area may be taken if a custom insert is fabricated.
2. Insert Fabrication: The insert is created from silicone gel, elastomeric material, or an equivalent substance, either custom-made from the mold or selected from prefabricated options.
3. Attachment: The insert is fitted into the existing prosthetic socket and adjusted for optimal comfort and fit.
4. Locking Mechanism Integration: The insert is integrated with the prosthetic’s locking mechanism to ensure stability.

Tools and equipment used may include casting materials, silicone molding components, fitting tools, and adhesives. Anesthesia is generally not required.

Duration

The procedure typically takes 1-2 hours.

Setting

The procedure is usually performed in an outpatient clinic or a prosthetics facility.

Personnel

• Prosthetist
• Prosthetic Technician

Risks and Complications

• Allergic reaction to materials used (rare)
• Improper fit leading to discomfort or the need for further adjustment
• Skin irritation or pressure sores
• Mechanical failure of the insert or locking mechanism

Benefits

• Enhanced comfort and fit of the prosthesis
• Improved stability and functionality
• Better overall prosthetic control
• Immediate improvement post-fitting

Recovery

• Follow-up appointments may be necessary to fine-tune the fit and functionality.
• Patients can expect to resume normal activities with their prosthesis immediately after any minor adjustments.
• Skin care regimen to prevent irritation or sores as the body adjusts to the new insert.

Alternatives

• Adjustments or modifications to the existing prosthesis without the insertion of a new socket.
• Different types of socket liners or cushioning materials.
• Switching to a different prosthetic model or design.

Pros and cons of these alternatives vary; some might offer less comfort or stability compared to the described procedure.

Patient Experience

Patients may feel some pressure during the fitting but should not experience significant pain. After the procedure, patients might feel immediate relief and improved fit. Pain management generally involves over-the-counter pain relievers if discomfort occurs. Proper follow-up care ensures lasting comfort and functionality.