HART’S ORTHOPEDIC Bracing Reference Guide
Hart Orthotics & Prosthetics
(888) 606-8778 | hartmedical.org MKBR00401
TABLE OF CONTENTS
ANKLE & FOOT 5-6 Ankle Stirrup 5 Lace Up Ankle / Figure 8 Ankle 5 Walking Boot 5 Rigid (Velocity Style) Ankle Brace 5 Posterior Night Splint / Dorsal Night Splint / PRAFO Boot 6 Prefab Carbon AFO 6 Custom Foot and Ankle Bracing 6 KNEE BRACING 7-9 Basic Hinged Knee Brace 7 Hinged Patella Stabilizer Brace 7 Reaction Brace 7 Knee Immobilizer 7 TROM 8 Playmaker KO 8 Medial/Lateral Unloader OA 8 ACL/PCL Brace 8 Custom Knee Braces 9 HIP BRACING 9 Hip Abduction Brace 9 Hip Unloader Brace 9 UPPER EXTREMITY 10-11 Abduction Sling 10 ROM Elbow Brace 10 Humeral or Ulnar Fracture Brace 10 Ulnar Gutter / Radial Gutter Splint 10 Resting Hand Splint 11 Cubital Tunnel Splint 11 Cock-up Wrist Splint 11 Thumb Spica 11 SPINAL BRACING 12-13 Rigid Cervical Collar 12 Low Profile LSO 12 LSO Back Brace 12 TLSO 12 Posture Control TLSO 13 Prefab Scoliosis Brace 13 Custom Spinal 13 DESCRIPTION OF SERVICES
Hart Orthotics and Prosthetics is comprised of a highly trained and certified, clinical practitioner team who works hard to provide quality and functional bracing to meet individual needs. We strive to provide our patients the knowledge and confidence to excel in their short and long term treatment goals. We offer a variety of custom and prefabricated bracing for upper and lower extremities, and we cast and/or measure as well as custom fit braces to accommodate the unique anatomy of every patient. Additionally, we educate patients regarding care, use, and fit and answer all questions or concerns. To ensure complete confidence, we offer free follow up appointments as needed.
CONTACT INFORMATION
The staff at Hart Orthotics and Prosthetics takes great pride in being a resource for clinicians and patients. If you have a question about any of the products or services we offer, we’re ready to help. Here’s how you can reach us:
WEBSITE: hartmedical.org MAIN LINE: (888) 606-8778 ORTHOTICS: (248) 304-4564
To download a digital version of this booklet, please go to hartmedical.org/guides.
4 ANKLE & FOOT
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Mild to moderate ankle sprains
Chronic ankle instability Rigid stirrup with Diagnosis of Ankle Sprains or padding to limit ankle Post-cast and post Fractures M/L movements walker support
Ankle injury rehabilitation and/or post-surgical use Ankle Stirrup
Ankle injury rehabilitation or immobilization Lace up ankle brace for (Grade I/II sprains) Diagnosis of Ankle Sprains or long-term wear with or Fractures without figure 8 straps Support chronic instability
Prophylactic use
Lace Up Ankle / Figure 8 Ankle
Foot and ankle conditions that may Orthopedic Walking benefit from motion Boots are designed to restriction, such as: Tall boot used for several foot protect the foot and Grade 2 and 3 ankle and ankle injuries ankle after an injury sprains, stable foot or surgery. Comes in fractures, or tendon/ Low profile walking boot pneumatic for greater ligament sprain recommended for 2nd, 3rd, or compression and low 4th metatarsal and toe fractures profile for metatarsal If used with the Achilles only fractures Wedge Kit, Achilles Ruptures can be treated as well. Walking Boot
Conditions that may benefit from ankle Rigid Hinged Ankle stabilization such as: Brace used for Grade 1, 2, 3 and high maximum protection, ankle sprains, transition Diagnosis of Ankle Sprains or typically for athletes out of a walker, and/ Fractures and highly active or cast after fracture patients or surgery, chronic ankle instability, or prophylactic use Rigid (Velocity Style) Ankle Brace 5 ANKLE & FOOT
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Conditions that may benefit from resting Patient must have diagnosis with the ankle in a of Plantar Fasciitis or Ankle neutral position, such Places the ankle in a Contracture. No other as: Plantar Fasciitis or neutral position, not for diagnoses are valid. Achilles Tendinopathy use during ambulation Insurance will not cover PRAFO PRAFO Boots are boots for ulcers. designed to protect from heel ulcers Posterior Night Splint / Dorsal Night Splint / PRAFO Boot
Drop foot secondary to: Cerebrovascular Prefabricated Accident (CVA), other lightweight carbon neurological conditions, AFO. Holds foot in Patient must be ambulatory Multiple Sclerosis, neutral position during and have a documented ankle mild knee instability, or ambulation. condition that could benefit Charcot-Marie-Tooth from this type of device. Disease Anterior and posterior styles available Works well for partial foot patients Prefab Carbon AFO
Foot orthotics are rarely Unlimited options covered by insurance, but there including AFOs, KAFOs, are some exceptions. Plantar Fasciitis and Arizona Braces, CROW multiple other podiatric Boots, Richie Braces, Plantar Fasciitis patients will conditions and custom foot receive accommodative orthotics orthotics with neutral posting unless otherwise noted.
Custom Foot and Ankle Bracing
6 KNEE
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Prescription must mention hinges “Hinged Knee Brace.” Typically used for minor Lightest knee brace sprains and instability covered by insurance Several diagnoses, excluding "Pain" Often used after Provides stabilization injections to provide with lightweight medial Patient must be ambulatory compression and and lateral hinges and have documented knee stability instability, weakness, or Comes in wrap-around deformity. Used for patients with (shown) and pull up both medial and lateral sleeve configurations Not Covered: Knee Brace, Knee bicompartmental OA Sleeve, Elastic Knee Brace, and Basic Hinged Knee Brace Genumedi Knee Brace
Several configurations Prescription must mention available based on hinges or specific brand patient’s condition and “Hinged Patella Stabilizer.” anatomy Typically used for Several diagnoses, excluding Chondromalacia Patella, Provides patella “Pain” Patellofemoral OA, tracking control and Jumpers Knee, M/L stability with Patient must be ambulatory Osgood-Schlatter hinges and have documented knee Disease, and Patellar instability, weakness, or Tendonitis Styles include deformity. U-Shaped Patella Stabilizer, Lateral J, and Not Covered: Knee Brace, Hinged Patella Stabilizer Brace Reaction Brace Lateral J, Patella Stabilizer
Several diagnoses, excluding “Pain”
Patellofemoral Prescription must state: Lightweight web-style conditions and “Reaction Style Knee Brace.” brace used for anterior Osgood-Schlatter knee conditions Disease Patient must be ambulatory and have documented knee instability, weakness, or deformity.
Reaction Brace
Temporary knee immobilization after injury
Easiest way to protect a Typically used while Typical diagnosis is Acute Knee knee and place into full waiting on results from Injury. extension imaging
For long-term immobilization, TROM is preferred Knee Immobilizer 7 KNEE
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Several diagnoses of severe Maximum knee knee injuries Range of motion post- stabilization for injuries op knee brace Must use diagnosis codes and Typically used post- not procedure codes (Z Codes) Can be locked in full operatively to protect extension knee and limit range of Please specify range of motion motion and patient instructions.
TROM
Long hinged knee brace that provides Commonly used for Typical diagnosis Knee maximum functional MCL or Meniscus Tears Derangement or MCL Tears M/L stability
Playmaker KO
Diagnosis must be Medial or Applies a Varus or Lateral Knee OA Valgus force to knee Used primarily for unicompartmental OA Must have specific OA diagnosis Multiple styles based either medial or lateral on patient’s activity level Must specify R, L, or B/L
Medial/Lateral Unloader OA
Typically used after Rigid framed brace for healed ACL tear for maximum stabilization returning to sport and functionality Can be used to protect Typical diagnosis Knee Can be custom ACL in nonsurgical Derangement or ACL/MCL fabricated for non- situations Tears standard sizes Maximum M/L and Documented Knee Instability Additional strapping rotational stabilization can be added for PCL injuries Restricts genu recurvatum ACL/PCL Brace 8 KNEE
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Several diagnoses, excluding “Pain” Custom knee braces Most types of knee Must use diagnosis codes and are for irregular sizes braces can be custom not procedure codes (Z Codes) and for long-term daily made. wear. Insurance varies, but patient typically must not be able to fit into a standard size brace.
Custom Knee Braces
HIP BRACING
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Post-operative hip revision patients, primary arthroplasty patients at risk of hip dislocation, patients Places hip in abduction Diagnosis of Chronic needing stability after and flexion to allow Dislocations or Hip Surgery dislocation, inoperable ambulation Revisions patients requiring hip stabilization, or patients who can benefit from a hip orthosis to reinforce hip precautions Hip Abduction Brace
Hip brace that provides Specifically for Hip joint stabilization and OA Diagnosis of Hip OA also decreases the internal rotation and Can be single or “Pain” is not a valid diagnosis. adduction moment bilateral design during gait cycle
Hip Unloader Brace 9 UPPER EXTREMITY
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Typically used post Can be pre-fit and dispensed operatively after rotator Sling to immobilize 48 hours prior to surgery cuff surgery shoulder in abduction and flexion Must use diagnosis codes and Can be used to treat not procedure codes (Z Codes) shoulder injuries
Abduction Sling
Indications requiring elbow immobilization and/or range of motion restriction, including: Range of Motion Elbow stable fractures of the Can be pre-fit and dispensed elbow, distal humerus, Brace designed for 48 hours prior to surgery proximal radius or ulna, limiting the flexion and tendon and ligament extension of the elbow injuries or repairs, Must use diagnosis codes and joint collateral ligament not procedure codes (Z Codes) reconstructions, elbow hyperextension, triceps tendon repair, or chronic elbow injuries ROM Elbow Brace
Sarmiento style brace that controls humeral Best suited for stable Diagnosis of Humeral or Ulnar segments through mid-shaft fractures Fractures circumferential soft tissue compression
Humeral or Ulnar Fracture Brace
Can be used for partial hand fractures Provides positioning Can stabilize 4th, 5th for fractures or injuries or 3rd, 4th or 2nd, 3rd Diagnosis of Metacarpal to metacarpals, metacarpals Fractures phalanges, and MCP and IP joints Can be applied directly to stable fractures or after cast removal Ulnar Gutter / Radial Gutter Splint 10 UPPER EXTREMITY
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Adjustable splint used Used for hand Make sure to include hand for positioning wrist, contractures and can diagnosis; i.e., Hand Contracture hand, fingers, and be applied for after cast from CVA. thumb removal
Resting Hand Splint
Slint that immobilizes and positions the elbow Indicated for Cubital Diagnosis of Cubital Tunnel at 122º to help reduce Tunnel Syndrome, post- Syndrome pain and numbness surgical application, or associated with Cubital post-cast removal Indicate R, L, or B/L Tunnel Syndrome
Cubital Tunnel Splint
Carpal Tunnel Syndrome
Mild to moderate sprains and strains Lightweight splint to Several diagnoses, excluding immobilize wrist Tendonitis “Pain”
Post cast healing
Other select soft tissue injuries Cock-up Wrist Splint
Gamekeeper’s thumb
Selected scaphoid injuries Similar to wrist splint Several diagnoses, excluding but with added thumb Soft tissue injuries “Pain” stabilization De Quervain’s Tenosynovitis
Post-cast healing Thumb Spica 11 SPINAL BRACING
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Situations requiring gross immobilization of the cervical spine: Diagnosis of Neck Injury pre and post C spine Adjustable collar for surgery, C spine, or If fit in the hospital and the neck immobilization precaution for trauma patient is not discharged within patients 48 hrs from delivery, the facility is responsible for payment. Can be pre-fit prior to surgery
Rigid Cervical Collar
For lower back conditions that Several lumbar diagnoses, may benefit from except “Pain” Low Profile Lumbar compression and gross Brace designed for motion restriction, If fit in the hospital and the day to day lumbar such as: lower back patient is not discharged within conditions pain (Lumbago), 48 hrs from delivery, the facility Lumbosacral Sprain/ is responsible for payment. Strain, or Degenerative Joint/Disc Disease
Low Profile LSO
Conditions requiring gross immobilization of the trunk in the lumbar Several lumbar diagnoses, region such as: stable, except “Pain” Back brace designed non-displaced spinal to stabilize the lumbar fractures (L1-L5), Spinal If fit in the hospital and the spine in 3 planes Stenosis, herniated patient is not discharged within discs, degenerative 48 hrs from delivery, the facility spinal pathologies, is responsible for payment. Spondylolysis, or Spondylolisthesis LSO Back Brace
Conditions requiring gross immobilization of the thoracic and lumbar spine. Such conditions Several lumbar and thoracic may include: Post- diagnoses, except “Pain” Back brace designed surgical immobilization, to stabilize the lumbar Spinal Support If fit in the hospital and the and thoracic spine in 3 TLSO Attachment patient is not discharged within planes up to T7, Spinal 48 hrs from delivery, the facility Stenosis, herniated is responsible for payment. disc, degenerative spinal fractures, or Spondylolisthesis TLSO 12 SPINAL BRACING
DEVICE PRESCRIPTION COMMON USES DESCRIPTION REQUIREMENTS
Back pain caused by stable vertebral compression fractures Diagnosis of Stable Anterior Lighter version of TLSO (VCF) Compression Fracture or specifically designed to Kyphosis control Kyphosis Thoracic Kyphosis “Pain” is not a valid diagnosis. Post-operative immobilization
Posture Control TLSO
Prefabricated Scoliosis Designed to limit pain Diagnosis of Scoliosis Brace designed for daily due to adult Scoliosis wear for adult Scoliosis and postural conditions “Pain” is not a valid diagnosis. patients
Prefab Scoliosis Brace
Patient must have a need for a Custom fabricated custom fabricated brace. Conditions similar to spinal bracing LSO and TLSO, such as: designed for patients Must use diagnosis codes and fractures and post-op who need maximum not procedure codes (Z Codes) situations immobilization “Pain” is not a valid diagnosis.
Custom Spinal
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