Comparative Effectiveness of Socket Casting Methods: Improving Form and Fit
Abstract
Objective/Rationale: One of the most important components of restoring function in persons with lower limb amputation is the precise and comfortable fitting of the prosthetic socket to the remaining limb, which is challenging because the remaining limb is dynamic in shape and volume. Additionally, every person’s remaining limb shape is different, requiring a custom-made socket. The most commonly used method of capturing the shape of the remaining limb for socket fabrication is to wrap plaster or fiberglass bandages around the remaining limb in a non-weight-bearing position and massage the bandages so that they conform to the shape of the limb. However, when using this technique, it is difficult to accurately capture the contours of the bony anatomy and to distribute pressure evenly around the limb. To improve this shape capture process, a standing pressure casting technique has been developed wherein the remaining limb is placed in a cylinder of water that is pressurized to support body weight. Pressure casting potentially offers a standardized procedure to produce sockets with repeatable results that are less dependent on the manual skill and experience of the prosthetist. Suggested advantages of the standing hydrostatic pressure casting technique include ease of use, less manipulation of the shape by the prosthetist, improved prosthesis delivery time, and potentially a more comfortable socket “right out the gate.” Therefore, the overall objective of this project is to compare hand casting to standing hydrostatic pressure casting using a water cylinder, specifically to compare consistency and efficiency of the casting processes, as well as fit and comfort of the resulting socket in persons with lower limb amputation. Applicability and Potential Impact of the Research: Issues with socket fit and comfort are common among lower limb prosthesis users. Additionally, socket refits are common, expensive, frustrating, and burdensome to the prosthesis user. The proposed work will impact the healthcare needs of people living life with a lower limb amputation by potentially improving prosthetic socket fit and comfort, as well as the time required to fabricate a prosthetic socket. This may be accomplished by improving the consistency and efficiency of the casting process that forms the foundation of prosthetic socket fabrication. Types of Patients That Will Be Helped by the Research: Patients with below- or above-the-knee amputation who wear a prosthesis will be helped by this research given that they all have to undergo some form of remaining limb shape capture for the purposes of having a prosthetic socket made. This study may help them by demonstrating that an alternative shape capture method is advantageous in producing a more comfortable socket in a timely manner. Potential Clinical Applications and Benefits: This study will help us create the evidence necessary to show whether standing hydrostatic pressure casting is a better alternative to conventional hand casting for prosthetic socket fabrication. Such evidence is needed for new technologies to become available to patients. Projected Timeline to Achieve Patient-Related Outcomes: The study will take 3 years to complete. The Symphonie Aqua System™ became commercially available recently in the US; hence, evidence to support its clinical implementation can be readily applied. Additionally, we anticipate generating a variety of knowledge products as part of the project. These knowledge products include publishing peer-reviewed publications that can contribute to clinical practice guidelines, creating educational materials for prosthetists interested in using standing hydrostatic pressure casting, and informational videos for persons with lower limb amputation interested in learning about casting options. Benefit to Service Members, Veterans and/or Their Family Members: This study will help us create the evidence necessary to show whether standing h
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910835
Entities
People
- Stefania Fatone
Organizations
- Northwestern University
- United States Army