Comparison of transhumeral socket designs utilizing patient assessment and in vivo skeletal and socket motion tracking: a case study

Abstract

Purpose: This case study compares the impact of two prosthetic socket designs, a “traditional” transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket. Methods: A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology). Results: Subjects were more satisfied with the comfort of the traditional sockets, although they had positive impressions about aspects of the fit and style of the CRS socket, and thought that it provided better control. Dynamic kinematic assessment revealed that the CRS socket provided better control of the residual limb within the socket, and had less slippage as compared to a traditional TH socket design. Conclusions: The TH CRS socket provided better control of the residual limb within the socket, and had less slippage. However, participants were less satisfied with the comfort and overall utility of the CRS socket, and stated that additional fitting visits/modifications to the CRS socket were needed. It is possible that satisfaction with the CRS socket may have improved with prosthetic adjustment and more acclimation time.

Implications for Rehabilitation

• A comfortable, good fitting prosthetic socket is the key factor in determining how long (or if) an upper limb amputee can tolerate wearing a prosthesis.

• This case series was a comparison of two socket designs, a 'traditional' socket design and a Compression Released Stabilized (CRS) socket design in persons with transhumeral amputation.

• The CRS socket provided better control of the residual limb within the socket, and had less slippage. However, its tightness made it more difficult to don.

• Both subjects were less satisfied with the comfort and overall utility of the CRS socket. However, satisfaction might have been improved with additional fitting visits and more acclimation time.

• Amputation
• biomechanics
• evaluation
• kinematic
• motion
• prosthesis
• radiography
• upper limb

Declaration of interest

This work was supported by VA RR&D A9227-P. The study was registered through clinical trials.gov, registration NCT01546675.

Linda Resnik: obtained research funding, designed the study, was responsible for overall conduct of the study, participated in data analysis, interpretation, writing and reviewing manuscript.

Christopher Fantini: participated in study design, was responsible for prosthetic fitting of subjects, aided in data interpretation, manuscript preparation and review.

Shane G. Cooney: conducted data analysis of XROMM and kinematic data, participated in manuscript writing, preparation of video data, and manuscript review.

Tarpit Patel: conducted data analysis of XROMM and kinematic data, participated in manuscript writing, and manuscript review.

Joseph Cirsco: participated in study design, led XROMM and kinematic data analysis, responsible for manuscript preparation and review.

Supplementary material available online