Additions to Lower Extremity
AK Custom Shaped Cover and Flexible Protective Outer Surface Covering System
Custom Shaped Cover
A custom shaped cover is made of flexible foam that is attached to the outside of a definitive prosthesis and then shaped to resemble the sound side limb as closely as possible.
Flexible Protective Outer Surface Covering System
A flexible protective outer surface covering protects the prosthesis from excessive wear and adds cosmesis (makes it more attractive). This “skin” is applied to the foam once the patient receives a definitive prosthesis and the custom shaped cover is complete.
BK Custom Shaped Cover and Flexible Protective Outer Surface Covering System
Custom Shaped Cover
A custom shaped cover is flexible foam which is attached to the outside of a definitive prosthesis and then shaped to resemble the sound side limb as closely as possible.
Flexible Protective Outer Surface Covering System
The flexible protective outer surface covering protects the prosthesis from excessive wear and adds cosmesis (makes it more attractive). This “skin” is applied to the foam once the patient receives a definitive prosthesis and the custom shaped cover is complete.
Compression Socks
Compression socks are elastic stockings manufactured to help control edema (swelling) in the residual limb. These stockings are available in varying degrees of compression. They are often used by new amputees during healing and by patients who require help with ongoing fluid control.
Custom Designs
Custom designs may be applied to a finished prosthesis to express a person’s individuality. This service is typically not covered by insurance companies since it is not considered a medically necessary addition.
K Levels
Prosthetic K-Level Evaluation
A system has been devised to “rate” functional level as they relate to component selection. Medicare created this system to ensure appropriate components are used. For example, if your physician feels you have the potential to be able to walk around the house but you will not have the strength or ability to walk on uneven surfaces or to climb curbs and stairs, you would be rated as a household ambulator (walker), ability level K1.
You would be provided with components that would be appropriate for your activity level. Components that are designed for higher activity levels would not be covered for payment under the Medicare policy. Your physician determines your functional ability level. If your functional ability increases over time, your rating can be changed to a higher level.
Functional level 0: The patient does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance his/her quality of life or mobility.
Functional level 1: The patient has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. This is typical of the limited and unlimited household ambulator.
Functional level 2: The patient has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs, or uneven surfaces. This is typical of the limited community ambulator.
Functional level 3: The patient has the ability or potential for ambulation with variable cadence. This is typical of the community ambulator who has the ability to traverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion.
Functional level 4: The patient has the ability or potential for prosthetic ambulation that exceeds basic ambulation skills, exhibiting high impact, stress, or energy levels. This is typical of the prosthetic demands of the child, active adult, or athlete.
** In an effort to be compliant with insurance regulations, we are required to have in our notes the physician’s evaluation of the amputee patient. The doctor’s evaluation MUST indicate the appropriate K-Level above (potential is the key word. He/she may currently be a K-Level 2, but has the ability to be a K3). Doctor’s notes should detail when and why they have seen the patient and what his expectations are. Some suggestions might be; with the prosthesis, patient will be ambulatory, able to exercise, drive, climb stairs, mow lawn, shop, and cook, and be independent.
Nylon Sheath
A nylon sheath is a thin nylon stocking with a very tight weave used to protect the patient’s skin. Patients will use these in conjunction with prosthetic socks or compression socks.
Prosthetic Additions
Molded Distal Cushion
A molded distal cushion is located at the bottom of the soft insert. It provides protection for the distal end (bottom) of the residual limb. It also allows the prosthetist to adjust the fit of the socket with respect to anatomical changes in the residual limb.
Alignable System
In an alignable system the prosthesis has movable parts to allow for rotation, height/length adjustment, and linear and angular changes of the prosthesis.
Ultralight Materials
Ultralight materials are used in the fabrication of a finished prosthesis. This refers to using the lightest and strongest materials available, such as acrylic resin, carbon fiber, fiberglass, and titanium.
Total Contact
Total contact refers to all surfaces of the residual limb touching the inside of the prosthetic socket or soft insert. This does not mean that there will be equal weight bearing on all surfaces of the limb; however, this contact is crucial for controlling the volume of the limb and protecting the skin. Without this contact, the patient may develop conditions that require medical attention.
Acrylic Socket
Acrylic socket is a term that refers to the type of resin used to fabricate a definitive prosthesis. An acrylic socket is lightweight and very durable.
Prosthetic Socks
When using a prosthesis with any type of suspension other than suction, the patient will need to use prosthetic socks. Prosthetic socks come in a variety of thicknesses, called sock ply. The socks are necessary to maintain comfort and to fine tune the fit of the prosthesis.
Test Socket
A test socket is a clear diagnostic socket that allows the prosthetist to evaluate the fit of the prosthesis before making the permanent device. Each time a new prosthesis is made, the patient will be fit with a test socket