Name of the Procedure:

Terminal Device, Passive Hand/Mitt, Any Material, Any Size (HCPCS L6703)

Summary

The procedure involves fitting a patient with a passive hand or mitt prosthesis. This device is designed to replace a missing hand or part of the hand, providing a functional and aesthetic solution to aid in daily activities, even though it does not have active movement capabilities.

Purpose

The primary purpose of this passive hand/mitt is to address the absence of a hand or part of the hand due to congenital conditions, trauma, or medical amputation. The device helps improve the patient's appearance and supports non-active functions such as stabilizing or carrying objects. The expected outcome is an enhanced quality of life and increased independence.

Indications

• Congenital limb deficiency
• Traumatic loss of hand or part of the hand
• Medical amputation due to conditions like severe infection or tumors
• Patient desire for improved cosmetic appearance

Preparation

• A thorough medical history and physical examination
• Measurements and photographs of the residual limb
• Possible diagnostic imaging to assist in custom fitting
• Pre-fitting consultation to discuss goals and expectations

Procedure Description

1. Initial Assessment: A healthcare provider assesses the residual limb and takes precise measurements.
2. Custom Design: A prosthetist designs the passive hand/mitt tailored to the patient's needs.
3. Fitting Session: The patient tries the device, and adjustments are made for optimal fit and comfort.
4. Training: The patient receives instructions on how to don, doff, and care for the device.

Tools involved:

• Soft measuring tape, scanners, or casting materials for accurate measurement
• Prosthetic components made of various materials like silicone, plastics, or composites

Duration

The fitting process typically involves multiple sessions over a few weeks, with each session lasting about 1-2 hours.

Setting

The procedure is performed in a specialized prosthetics and orthotics clinic or a rehabilitation center.

Personnel

• Prosthetist
• Occupational therapist (optional, for training and adaptation)
• Prosthetic technician (for custom fabrication)

Risks and Complications

• Skin irritation or pressure sores
• Improper fit leading to discomfort or limited usability
• Potential need for adjustments or replacements over time

These issues can generally be managed with prompt follow-up care.

Benefits

• Improved cosmetic appearance
• Enhanced functionality for specific tasks
• Increased self-esteem and social confidence
• Quick adaptation time post-fitting

Recovery

• Minimal recovery time
• Immediate use of the device with ongoing adjustments as needed
• Follow-up appointments for fine-tuning and monitoring

Alternatives

• Active prosthetic hands with mechanical or myoelectric components that provide movement
• No prosthesis, relying on adaptive techniques for daily tasks

Pros and cons of alternatives:

• Active prosthetics offer more functionality but are more complex and expensive.
• Choosing no prosthesis eliminates foreign body sensation but may limit functional capabilities.

Patient Experience

Patients can expect minor discomfort during initial fittings, such as pressure points or skin sensitivity, which typically improve. Proper instructions and wearing schedules are provided to ensure comfort. Pain management is rarely needed, but any discomfort can usually be alleviated by adjustments and using recommended skin care routines.