Addition to Upper Extremity Prosthesis, Above Elbow Disarticulation, Ultralight Material (Titanium, Carbon Fiber, or Equivalent)

Name of the Procedure:

• Common Name: Above Elbow Prosthesis Addition
• Technical Term: Addition to Upper Extremity Prosthesis, Above Elbow Disarticulation, Ultralight Material (HCPCS Code L7401)

Summary

This procedure involves adding an ultralight prosthesis to the upper extremity for patients who have undergone an above elbow disarticulation. The prosthesis is crafted from advanced materials such as titanium or carbon fiber, making it both strong and lightweight to enhance functionality and comfort.

Purpose

• Medical Conditions: This procedure addresses limb loss due to trauma, congenital conditions, or medical illnesses that necessitate an above-elbow amputation.
• Goals: The primary goal is to restore as much upper limb function as possible, improving the patient's ability to perform daily tasks and enhancing quality of life.

Indications

• Symptoms/Conditions: The patient has undergone an above elbow disarticulation.
• Criteria: Patients who are suitable candidates include those with adequate residual limb health and who can handle the weight and maintenance of the prosthesis. Psychological readiness and commitment to rehabilitation also play crucial roles.

Preparation

• Pre-procedure Instructions: Patients may need to modify certain medications and avoid eating or drinking if anesthesia is required.
• Diagnostic Tests: A thorough medical and physical evaluation, including imaging studies of the residual limb, to customize the prosthesis.

Procedure Description

1. Assessment: Evaluation of residual limb and measurement for custom-fitting the prosthesis.
2. Customization: Crafting the prosthesis from ultralight materials such as titanium or carbon fiber.
3. Fitting: Attaching the prosthesis to the residual limb, followed by adjustments for optimal fit and function.
4. Training: Instruction on how to use and maintain the prosthesis, which may include physical therapy sessions.

• Tools and Equipment: Advanced materials like titanium and carbon fiber, specialized fittings, and adjustment tools.
• Anesthesia: Local or regional anesthesia if necessary for comfort during fitting and adjustment.

Duration

Typically, the entire process from assessment to fitting may take several hours to a few days, depending on individual case complexity and the need for customization.

Setting

• Location: This procedure is generally performed in a specialized outpatient clinic or a hospital with a dedicated prosthetics department.

Personnel

• Healthcare Professionals: Prosthetists, orthopedic surgeons, rehabilitation specialists, physical therapists, and occasionally anesthesiologists.

Risks and Complications

• Common Risks: Skin irritation or pressure sores.
• Rare Risks: Prosthetic malfunction, allergic reaction to materials, or poor fit requiring adjustments.

Benefits

• Expected Benefits: Enhanced limb function, improved ability to perform daily activities, and increased quality of life. Benefits often realized within weeks to months as the patient adapts to the prosthesis.

Recovery

• Post-procedure Care: Regular follow-up visits for adjustments and monitoring.
• Recovery Time: Patients may take several weeks to a few months to fully adapt and achieve optimal function.
• Restrictions: Depending on the individual, some activities may be limited initially.

Alternatives

• Other Options: No prosthesis, use of a simpler or heavier prosthesis, or robotic prostheses.
• Pros and Cons: Simpler prostheses may not offer the same level of function but are less expensive, while robotic options can be more advanced but significantly costlier and may require more maintenance.

Patient Experience

• During the Procedure: Minimal discomfort if anesthesia is used.
• After the Procedure: Patients might feel some sensation changes in the residual limb and will need to learn to use the new prosthesis. Pain management and comfort measures include medication and physical therapy sessions to ensure a smooth adaptation process.