Name of the Procedure:

• Common Name(s): Prosthetic Addition for Below Elbow/Wrist Disarticulation
• Technical Term: Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material (HCPCS Code: L7403)

Summary

The procedure involves adding a new acrylic component to an existing prosthetic limb for individuals who have had a below elbow or wrist amputation. The acrylic material is custom-fitted to enhance the functionality and comfort of the prosthesis.

Purpose

The primary goal of this procedure is to improve the functionality and durability of the prosthetic limb for better day-to-day use. It helps individuals regain improved arm and hand functions lost due to amputation, enabling them to perform activities of daily living more easily and efficiently.

Indications

• Below elbow or wrist disarticulation requiring enhanced prosthesis functionality.
• Patients experiencing discomfort or functional limitations with their current prosthesis.
• Individuals seeking upgrades or replacements for deteriorated prosthetic components.

Preparation

• No fasting required.
• Patients should ensure they have all relevant medical records and prescriptions available for review.
• A thorough evaluation, including measurements and fitting tests, will be conducted by the prosthetist.

Procedure Description

1. Assessment: Initial assessment of the existing prosthetic limb to identify necessary enhancements.
2. Fitting: Customized fitting of the acrylic component to match the patient's residual limb.
3. Molding: Molding and shaping of the acrylic material for optimal comfort and function.
4. Attachment: Secure attachment of the new acrylic component to the prosthesis.
5. Adjustments: Final adjustments and tests to ensure proper fit and functionality.

Duration

• Typically completed within 1-2 hours.

Setting

• Usually performed in a specialized prosthetics and orthotics outpatient clinic.

Personnel

• Certified prosthetist or orthotist.
• Possible assistance from a nurse or a prosthetic technician.

Risks and Complications

• Minor risks include skin irritation or pressure sores at the attachment site.
• Rare risks involve allergic reactions to the acrylic material.
• Potential for misalignment or poor fit, necessitating additional adjustments.

Benefits

• Enhanced prosthetic function enabling more natural, comfortable movement.
• Increased durability of the prosthesis.
• Potential for improved quality of life and independence.
• Benefits are often realized immediately after the procedure and enhanced over time with use.

Recovery

• Minimal recovery time; patients can usually use the upgraded prosthesis immediately.
• Instructions for care and maintenance of the new component will be provided.
• Follow-up appointments may be scheduled to ensure optimal fit and function.

Alternatives

• Use of different materials such as silicone or carbon fiber components.
• More advanced prosthetic technologies, e.g., myoelectric prostheses.
• Each alternative has its own advantages and disadvantages in terms of cost, functionality, and comfort.

Patient Experience

• Most patients report a feeling of increased support and stability immediately following the addition.
• Minor discomfort during the fitting process, managed with comfort measures.
• Post-procedure, patients may experience a short adjustment period as they get accustomed to the new component.
• Pain management is typically minimal, with over-the-counter pain relievers if necessary.