Abstract
Transtibial prosthesis socket trim lines have remained fairly consistent over the past decade, and based on methods such as a supracondylar cuff suspension. However, with vacuum suspension methods, trim lines can change. An objective of this technical note was to inform practitioners how to fabricate a socket in a better way. A step-by-step fabrication guide is provided for the prosthetist. A unilateral transtibial amputee was selected for this technical note. We provide a detailed description of the different steps of fabrication as well as patient feedback. The fabrication involved fabrication of a vacuum socket using Pre-preg carbon fiber and anti-bacterial Ethylene-Vinyl-Acetate (EVA), as a proximal flexible brim. The properties of EVA and Pre-preg carbon fiber allow for fabrication of a transtibial socket with a flexible proximal brim. The new design resulted in greater comfort and increased range of motion in the patient studied. The patient subjectively noted enhanced squatting and cycling capabilities while using the updated socket and flexible proximal brim. This technical note presented a fabrication guide for a new style of socket and preliminary patient feedback. Clinical studies evaluating functional and biomechanical effects of this new socket design are needed.
Highlights
Transtibial prosthesis socket trim lines have remained fairly consistent over the past decade, and based on methods such as a supracondylar cuff suspension
A unilateral transtibial amputee was selected for this technical note
Prosthetic interface, socket technologies and suspension variants have evolved in recent years to allow for a greater adjustability of the prosthesis to the extremity
Summary
Prosthetic interface, socket technologies and suspension variants have evolved in recent years to allow for a greater adjustability of the prosthesis to the extremity. Numerous transtibial prosthesis technologies work to facilitate an improved dynamic fitting or aid the overall function of the individual.[1] Various modifications to the socket can augment suspension characteristics and even assist gait of the user.[2] Some companies have focused on utilizing ratcheting technologies to aid in adjustability of the prosthesis socket, such as the BOA system (Click Medical, BOA, Steamboat Springs, Colorado, USA). In this same vein, it is important to augment the range of motion for individuals with specific seating, cycling, kneeling and walking requirements.
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