Article

The fit and function of a prosthetic socket depend on the
prosthetist's ability to design the socket's shape to distribute load comfortably
over the residual limb. We recently developed a sub-ischial socket for persons
with transfemoral amputation: the Northwestern University Flexible Sub-Ischial
Vacuum Socket. This study aimed to quantify the rectifications
required to fit the Northwestern University Flexible Sub-Ischial Vacuum Socket to
teach the technique to prosthetists as well as provide a computer-aided
design-computer-aided manufacturing option. STUDY DESIGN: Development project.
METHODS: A program was used to align scans of unrectified and rectified negative
molds and calculate shape change as a result of rectification. Averaged
rectifications were used to create a socket template, which was shared with a
central fabrication facility engaged in provision of Northwestern University
Flexible Sub-Ischial Vacuum Sockets to early clinical adopters. Feedback
regarding quality of fitting was obtained. RESULTS: Rectification maps created
from 30 cast pairs of successfully fit Northwestern University Flexible
Sub-Ischial Vacuum Sockets confirmed that material was primarily removed from the
positive mold in the proximal-lateral and posterior regions. The template was
used to fabricate check sockets for 15 persons with transfemoral amputation.
Feedback suggested that the template provided a reasonable initial fit with only
minor adjustments. CONCLUSION: Rectification maps and template were used to
facilitate teaching and central fabrication of the Northwestern University
Flexible Sub-Ischial Vacuum Socket. Minor issues with quality of initial fit
achieved with the template may be due to inability to adjust the template to
patient characteristics (e.g. tissue type, limb shape) and/or the degree to which
it represented a fully mature version of the technique.
Clinical relevance
Rectification maps help communicate an important step in the fabrication of the
Northwestern University Flexible Sub-Ischial Vacuum Socket facilitating
dissemination of the technique, while the average template provides an
alternative fabrication option via computer-aided design-computer-aided manufacturing and central fabrication.

Langue : ANGLAIS