Name of the Procedure:

Common Name:

Mechanical Voluntary Opening Hand

Technical/Medical Term:

HCPCS Code L6708 - Terminal device, hand, mechanical, voluntary opening, any material, any size

Summary

This procedure involves fitting a mechanical hand prosthesis designed to open voluntarily. It's a device that can be made from various materials and is available in different sizes to suit the needs of the patient. This type of prosthesis is controlled by the user and can grasp objects when the user exerts force on it.

Purpose

Medical Conditions or Problems it Addresses:

• Amputation of the hand or forearm
• Loss of hand function due to trauma or congenital conditions

Goals or Expected Outcomes:

• Restoring the ability to perform daily tasks
• Improving the patient's quality of life and independence
• Enhancing the functional and cosmetic appearance of the upper limb

Indications

Specific Symptoms or Conditions:

• Missing hand or forearm
• Limited functional ability of the residual limb
• Desire for a mechanical and non-electronic prosthetic option

Patient Criteria or Factors:

• Sufficient residual limb health to support a prosthesis
• Motivation to learn and adapt to using a mechanical device
• Appropriate size and fit requirements

Preparation

Pre-procedure Instructions:

• Ensure the residual limb is healthy and free from infection
• Attend a consultation to discuss the best prosthetic options
• Possible imaging (e.g., X-rays) to assess the residual limb structure

Diagnostic Tests or Assessments:

• Physical examination of the residual limb
• Measurements for custom-fitting of the prosthesis
• Psychological readiness and willingness to undergo prosthesis training

Procedure Description

Step-by-Step Explanation:

1. Initial consultation and evaluation by a prosthetist.
2. Measurement and casting of the residual limb.
3. Fabrication of the custom mechanical hand.
4. Fitting session where the prosthesis is attached to the residual limb.
5. Adjustment and alignment for optimal comfort and function.
6. Training sessions to learn how to operate the device effectively.

Tools, Equipment, or Technology:

• Mechanically operated terminal device (hand prosthesis)
• Casting materials for custom fitting
• Adjustment tools for alignment

Anesthesia or Sedation:

• Usually not required; the procedure is non-invasive.

Duration

• The fitting and initial training sessions can take a few hours to complete.
• Follow-up appointments may be necessary for additional adjustments and training.

Setting

• Prosthetic clinic or specialized outpatient facility

Personnel

• Certified prosthetist
• Physical or occupational therapist
• Support staff for scheduling and coordination

Risks and Complications

Common Risks:

• Discomfort or skin irritation at the site of attachment
• Mechanical failure or malfunction

Rare Risks:

• Infections
• Long-term skin issues due to prolonged use

Possible Complications Management:

• Regular follow-up visits to adjust the fit
• Skin care routine and appropriate hygiene practices

Benefits

• Restored ability to perform daily tasks like gripping and holding objects
• Enhanced independence and quality of life
• Improved cosmetic appearance

Recovery

Post-procedure Care and Instructions:

• Routine follow-up visits for adjustments
• Regular cleaning and maintenance of the prosthesis
• Adherence to training and exercise programs

Expected Recovery Time:

• Immediate use after fitting, with adaptation over several weeks

Restrictions or Follow-up Appointments:

• Regular check-ups to prevent and address any issues
• Potential activity modifications based on the prosthetist's advice

Alternatives

Other Treatment Options:

• Myoelectric prosthesis
• Cosmetic prosthesis
• No prosthesis

Pros and Cons of Alternatives:

• Myoelectric prosthesis: offers more functionality but requires power sources
• Cosmetic prosthesis: improves appearance but lacks functional ability
• No prosthesis: avoids any associated risks but limits independence

Patient Experience

During the Procedure:

• Minimal discomfort during fitting and adjustments
• Some physical activity during training sessions

After the Procedure:

• Possible initial discomfort that lessens with time and adaptation
• Gradual improvement in daily task performance
• Support and guidance from the prosthetic team for the duration