CPT® Code 29358

A long leg cast-brace is a specialized orthopedic device used to immobilize fractures located in the middle or distal femur. This type of cast-brace is designed to provide stability and support to the leg while allowing for some degree of mobility at the knee and hip joints. The construction of the cast-brace involves two main components: a patellar weight-bearing cast that covers the lower leg and an ischial weight-bearing cast that encompasses the thigh. These two sections are connected by external hinges positioned on both the medial and lateral sides of the knee, facilitating movement while maintaining immobilization of the fracture site. The application process begins with the use of a stockinette, which is placed over the entire leg from the thigh down to the toes, followed by padding to ensure comfort and protection. A plaster or fiberglass roll is then prepared by immersing it in water until saturated, after which excess moisture is removed. This material is carefully wrapped around the leg, typically starting from the distal (far) end and moving proximally (toward the body). To enhance the functionality of the cast-brace, plastic sockets are integrated into the upper section of the cast, allowing for the attachment of the external hinges. The plaster or fiberglass is then smoothed and molded to fit the contours of the leg. A critical step in the process involves cutting out the center portion of the cast over the knee, which enables the hinges to be affixed, thus permitting movement at both the knee and hip joints while still providing the necessary support for the healing fracture.