The relationship between residual limb health, motion within the socket, and prosthetic suspension

Abstract

Residual limb health is critical for continued prosthesis use; however, many prosthesis users experience skin‐related breakdown. The interface between the residual limb and the prosthetic socket sets the local mechanical environment and plays a role in skin stresses. Motion of the residual limb in the socket adds additional mechanical strain on the limb. This article explores the relationship between motion of the limb in the socket and residual limb health. We evaluated current methods for assessing residual limb health and motion of the residual limb in the socket and compared these evaluations across different prosthetic suspension systems. While few direct studies comparing residual limb health and motion exist, it has been shown that elevated vacuum suspension systems result in both improved residual limb health compared to passive suction and pin‐lock systems and decreased motion compared to passive suction, pin‐lock, knee sleeve, and anatomical suspension systems. While motion and health have not been directly linked, elevated vacuum suspension may demonstrate a relationship that reduced motion of the residual limb in the socket improves residual limb health. Further evaluation in this area is necessary to more completely and directly understand the relationship between residual limb motion and residual limb health.

Mechanical testing of transtibial prosthetic sockets: A discussion paper from the American Orthotic and Prosthetic Association Socket Guidance Workgroup

“…The nonuniform geometrical shape of typical prosthetic sockets has led to difficulties, ambiguities, and misunderstandings in specifying or attempting to measure alignment. 30 The prosthesis–residual limb interface also acts as a pseudojoint with relative movements, 33 contributing further to complexity of prescribing alignment. Without an established and unified reference system, it is not possible to define an alignment, to compare results, or to establish a repeatable testing method among different studies, within the same facility and across different facilities.…”

Methodology to Investigate Effect of Prosthetic Interface Design on Residual Limb Soft Tissue Deformation

“…During ambulation, prostheses are loaded dynamically and movement of the residual limb bones with respect to the socket wall occurs. 34 The methodology presented in this report only looks at a static loading condition. Using this methodology to compare different levels of static loading while wearing the same interface would go some way to understanding how different interface designs influence residual limb soft tissue deformation during prostheses use.…”

3D Scan to Knit - Workflow and Challenges of Automated Data Processing and Knit Program Generation for Prosthesis Liners

“…Silicon is chosen because of its biocompatibility, flexibility and high friction coefficient with skin [5,28]. The connection between Liner and prothesis is either facilitated only trough friction, or by using a pin, which is attached to the liner and locks into the prothesis [29]. The liner propagates and distributes normal shear stresses between the limb and the prothesis; protecting the residual limb tissues and sensitive regions such as bony prominences that are not accustomed to bearing loads, while it also facilitates limb heat transmission and enhances comfort [3,30,31].…”