Name of the Procedure:

Common Name: Terminal Device Attachment
Technical/Medical Term: Terminal Device, Sport/Recreational/Work Attachment (HCPCS Code: L6704)

Summary

A terminal device attachment is a component added to a prosthetic limb to help individuals engage in specific activities or tasks, such as sports, recreational activities, or work-related functions. These attachments are specialized to provide better performance and adaptability in various scenarios.

Purpose

Medical Conditions: Used for individuals with limb loss or limb differences who need tailored prosthetic solutions for specific activities. Goals/Expected Outcomes: To improve functionality, enhance quality of life, and allow users to effectively participate in sports, recreational activities, or job-related tasks with greater ease and efficiency.

Indications

Symptoms/Conditions Warranting the Procedure:

• Amputations
• Congenital limb differences

Patient Criteria:

• Individuals who actively participate or intend to participate in sports, recreational, or work activities requiring specialized prosthetic functionality.

Preparation

Pre-Procedure Instructions:

• No specific fasting or medication adjustments required.

• It is advisable to discuss activity goals with your healthcare provider to choose the most suitable attachment.

  Diagnostic Tests:

• Evaluation of the residual limb to determine appropriateness and fit.
• Activity analysis to tailor the attachment to specific needs.

Procedure Description

1. Assessment: A prosthetist assesses the patient's residual limb and activity requirements.
2. Fitting: An impression or digital scan of the residual limb may be taken.
3. Fabrication: The specific attachment is designed and manufactured based on the patient’s needs and specifications.
4. Attachment: The terminal device is attached to the existing prosthetic limb.
5. Adjustment: The prosthetist ensures proper fit and alignment.
6. Training: The patient receives training on how to use and maintain the new attachment.

Tools/Equipment: Specialized terminal attachment, alignment tools, and adjustment wrenches.

Anesthesia/Sedation: Not applicable.

Duration

The fitting and attachment process generally takes 1 to 2 hours, but this may vary depending on the complexity of the attachment.

Setting

Typically performed in a prosthetic clinic or specialized outpatient facility.

Personnel

• Primary: Certified Prosthetist
• Support: Technicians for manufacturing and adjustments

Risks and Complications

Common Risks:

• Discomfort or improper fit
• Skin irritation

Rare Risks:

• Damage to the residual limb
• Mechanical failure of the attachment

Management:

• Regular follow-ups for adjustments and assessments.

Benefits

• Enhanced ability to engage in targeted activities.
• Improved quality of life and psychological well-being.
• Increased independence and productivity.

Recovery

Post-Procedure Care:

• Regular use and practice with the new attachment.
• Follow-up appointments for adjustments and maintenance.

Expected Recovery Time:

• Immediate use after fitting with ongoing incremental improvement.

Restrictions:

• Specific to the activity; follow detailed instructions provided by the prosthetist.

Alternatives

Other Options:

• Standard prosthetic limbs without specialized attachments.
• Different designs of terminal devices tailored for other activities.

Pros and Cons:

• Standard prosthetic limbs may lack specialized functionality.
• Other terminal device designs offer similar benefits but may not be as tailored to the specific activities in question.

Patient Experience

During Procedure:

• Minimal discomfort during fitting and adjustment.

After Procedure:

• Some initial learning curve and adaptation period.
• Potential mild discomfort as the body gets used to the new attachment.

Pain Management and Comfort Measures:

• Over-the-counter pain relievers for initial discomfort.
• Regular check-ups to ensure comfort and proper function.