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Upper-Extremity Socket Designs: Advances in

Newer sockets are shaped to capture the anatomical features of the limb. This can provide better suspension and control of the prosthesis. One major change in suspension technique has been the application of roll-on liner suspensions for upperlimb prostheses.

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439 views3 pages

Upper-Extremity Socket Designs: Advances in

Newer sockets are shaped to capture the anatomical features of the limb. This can provide better suspension and control of the prosthesis. One major change in suspension technique has been the application of roll-on liner suspensions for upperlimb prostheses.

Uploaded by

cheeshing88
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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Advances in

Advances in Sockets

Upper-Extremity
Socket Designs by Wayne Daly, CPO, LPO, FAAOP

Newer sockets are shaped to capture the anatomical features of the limb,
which can provide better suspension and control of the prosthesis and, in
turn, increase the function of the limb. Examples of changes in socket shape
are the anatomic contoured transradial socket, the narrow ML (medial-
lateral) transhumeral design, and the X-frame socket used in shoulder
amputations.
Work by many practitioners has concentrated on using the Other designs to improve prosthetic function have evolved
anatomic contours of the forearm and torso to increase the for other lengths and levels of amputations. One such
suspension and range of motion (ROM) of the prosthesis. design is the narrow ML transhumeral socket, which incor-
One such transradial socket design is the Anatomically Con- porates a modified shape that takes advantage of the shape
toured and Controlled Interface (ACCI), which uses flexible of the residual limb to provide better rotational control
socket walls and fits the anatomic contour of the forearm and increased function. One such design modification,
to suspend the prosthesis (Illustration 1). By capturing the called the Utah Dynamic Socket, accentuates the shape of
shape of the elbow, it is often possible to improve the stabil- the upper arm to provide rotation control and improved
ity and ROM of a transradial prosthesis for a short residual suspension (Illustration 2). This socket, which may be used
limb. with either a sock fit or a skin fit, locks onto the contours
of the upper arm, providing a stable, highly functional
prosthesis.

Illustration 1 Illustration 2
Example of Anatomically Contoured and Controlled Interface socket. Comparison of narrow ML socket to conventional socket shape. Based on
Photo courtesy of Randall Alley, CP, FAAOP information from J. Thomas Andrew, CP, FAAOP. Used by permission.

14 inMotion Volume 13, Issue 5 September/October 2003


Illustration 3 Range of motion possible with a roll-on suspension prosthesis.

One major change in suspension volume changes in the limb. This


technique has been the application of ability to accommodate significant
roll-on liner suspensions for upper- volume changes allows a prosthesis to
limb prostheses, which provide not be fitted earlier in the healing process
only improved suspension, but also than a conventional design without
better comfort and greater range of loss of comfort or suspension.
motion for the prosthesis. Conven- This roll-on liner design can be
tional transradial self-suspending used for suspension with conven-
sockets rely on pressure above the tional or myoelectric arms. In the
elbow to hold the prosthesis in place myoelectric design, the electrodes are
and this can lead to discomfort and attached through the liner to
reduced ROM. With the roll-on
suspension design, the liner provides
the suspension, while the gel protects
the skin from pressure and friction.
The looser fit of the roll-on designs
can provide increased ROM since
the soft suspension allows the arm to
move in the socket and relieves many
of the pressure points associated with
a conventional self-suspending socket
design. Many liners also incorporate
mineral oil or aloe vera extract to
protect the skin from abrasion and
to help with scar tissue healing.
Another important consideration is
that conventional skin fit suction
socket designs use one-way air valves
or external sleeves for suspension
and require a stable limb volume to
maintain suction. Roll-on suction liner
designs provide a more flexible suspen- Illustration 4
sion that will accommodate greater Shielded cables and electrodes.

To support the ACA or to become a member, call 1-888/267-5669 15


provide more stable electrical control, better suspension,
and greater ROM (Illustration 3). This design uses stain-
less steel electrodes and shielded cables to send the myo-
electric signal from the remote electrodes, which improves
suspension and electrical contact (Illustration 4).
For higher-level amputations, other designs have
evolved to improve the fit and function of the prosthesis.
Shoulder-level amputations have often been difficult to
suspend and are often uncomfortable due to the large area
of skin covered by plastic. The poor stability of a shoulder
disarticulation socket has also limited the function of the
prosthesis. One design that seeks to reduce these problems
and increase the wearing comfort is the X-frame shoulder
socket. The X-frame socket uses very rigid materials to
maintain a shape that will lock into the wedge-shaped
anatomy of the upper torso, providing a secure anchor for
the prosthesis, which, in turn, increases its stability and
function. This shape allows the socket to be much smaller
and thinner, as well as cooler and lighter, while maintain-
ing secure suspension. With the use of newer carbon
composite lamination techniques, the production of thin,
lightweight, but very rigid, frames is possible for shoulder
prostheses. All of these changes provide better function
and usefulness for the prosthesis. 

About the Author


Wayne Daly, CPO, LPO, FAAOP, has 28 years experience
in the prosthetics and orthotics field. He is American Board
certified and was recently named a Fellow of the Academy. He
holds a Bachelor of Science in Prosthetics & Orthotics from
the University of Washington where he was a lecturer for seven
years.

16 inMotion Volume 13, Issue 5 September/October 2003

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