Getting your first prosthesis or brace: what to expect
A plain walkthrough of the usual steps: the order, evaluation, casting or scanning, fitting, adjustments and follow-up care.
Getting a first prosthesis or brace can feel unfamiliar, especially if it follows surgery, an injury or a new diagnosis. The steps below describe a typical process. Every clinic and every person is different, and the order and pace depend on your health, healing and the type of device.
Start with the order or prescription
Most O&P care begins with a referral or order from a physician or other qualified health professional, such as a surgeon, physiatrist, orthopedist or podiatrist. The order describes the condition and the type of device needed. Insurers, including Medicare, generally expect a written order and supporting medical records. Ask your prescriber which clinics they work with, and remember that you can usually choose the provider, subject to your insurance network rules.
The evaluation
At the first visit, the prosthetist or orthotist takes a history and examines you. Expect questions about your health, your work, your home, the activities you want to do and any past devices. For a limb prosthesis, they look at the residual limb: its shape, skin, sensation, strength and range of motion. For a brace, they look at alignment, movement and the area to be supported. Bring your order, insurance cards, a list of medications and any therapy notes. It is worth writing down goals in plain terms, such as walking on uneven ground, driving or returning to a hobby.
Measuring, casting or scanning
To make a custom device, the clinician needs the exact shape of your body. This is done with measurements, a plaster or wrap cast, or a digital scan. Some off-the-shelf braces are simply sized and adjusted on the day. The shape is then used to build a device, often starting with a trial or check socket for a prosthesis so that fit can be tested before the final version is made. Ask which method the clinic uses and how it will affect the timing of your first fitting.
Fabrication and first fitting
Custom devices are made in the clinic's lab or sent to a fabrication facility. Your clinic can give an estimate of when your device should be ready, but do not rely on a general timeline from the internet because materials, insurance approval and the complexity of the device all matter. At the fitting, the clinician checks comfort, alignment and function. For a prosthesis you may stand and walk between parallel bars or practice using an arm device. For a brace you practice putting it on and taking it off correctly.
Adjustments and training
A first device commonly needs several adjustments. Bodies change, particularly after amputation, when the residual limb can change in volume as swelling settles. Sock ply, liners or padding may be changed to keep the fit comfortable. Physical or occupational therapy is often part of the plan, especially for a first leg or arm. The clinician and therapist can teach wearing schedules, skin checks and safe use. Follow their guidance on how long to wear the device at first.
Contact the clinic promptly if you notice any of the following:
- Redness that does not fade, blisters, open areas or drainage.
- New pain, numbness or swelling.
- A device that feels loose, rubs, clicks or has changed in alignment.
- A sudden change in your weight or the size of your limb.
Follow-up and long-term care
O&P care continues after the first fitting. Expect scheduled follow-up visits, and ask how to reach the clinic between visits. Components wear out, needs change and growing children need frequent updates. Keep a record of your device, its components, warranty information and the dates of visits. Ask about cleaning and maintenance, and about where to go for a repair if the clinic is closed.
Insurance and paperwork
Before the device is made, the clinic usually checks your coverage and may request prior authorization or documentation. You can ask for a written estimate of what you may owe. See our guide to Medicare and insurance for more, or read what Medicare.gov says about prosthetic devices.
Resources
- The Amputee Coalition offers information and peer support for people with limb loss and limb difference.
- The VA Prosthetic and Sensory Aids Service provides information for eligible veterans.
- The FDA regulates medical devices and accepts reports of device problems.
This guide is general information, not medical advice. Your clinical team is the best source for what applies to you.