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UL Px > WK4: Socket Design & Suspension > Flashcards

WK4: Socket Design & Suspension Flashcards

1
Q

Main Goals

Socket Design for TR/WD

A
  • Serve as an interface (RL to Px)
  • Stable translation of forces (BP)
  • Work with or provide suspension
  • Allow/accommodate existing ROM
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2
Q

Other considerations

Socket Design for TR/WD

A
  • limb length
  • desired control
  • desired suspension
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3
Q

Describing Sockets

Socket Design for TR/WD

A

Donning
* Pull in
* Push in

Interfaces
* Skin
* Fitting socks
* Gel liner

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4
Q

Suspension Options

A
  • External
  • Self Suspending
  • Mechanical
  • Atmospheric
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5
Q

External

Suspension Methods

A

Harnesses

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6
Q

Self-Suspending

Suspension Methods

A

Anatomical

proximal or distal

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7
Q

Mechanical

Suspension Methods

A
  • Pin, Lanyard, or Magnet
  • requires gel liner
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8
Q

Atmospheric

Suspension Methods

A
  • Suction (liner or skin fit)
  • Active Vacuum (liner only)
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9
Q

Common Plaster Modifications

Socket Design for TR/WD w/ Harness Suspension

A
  • Reduce plaster in fleshy areas
  • Relieve over prominent bony landmarkes
  • Accentuate “screwdriver” shape
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10
Q

Bony Landmarks in TR/WD

Socket Design for TR/WD w/ Harness Suspension

A
  • Distal cut end of radius (TR)
  • Distal cut end of ulna (TR)
  • Distal end of radius and ulna (WD)
  • Lateral epicondyle
  • Medial epicondyle
  • Olecranon process
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11
Q

Trimlines

Socket Design for TR/WD w/ Harness Suspension

A

Trim lines will be higher for shorter limb lengths
- For WD or long TR, do not encompass
epicondyles
- For very short TR, as high as possible to still
allow donning and desired elbow ROM

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12
Q

Proximal Anatomical Self-
Suspending TR Socket Designs

A
  • developed in 1960s for very short TR limb differences
  • severely restrict voluntary pronation and
    supination
  • Well suited for passive prostheses (but can be used with BP and EP)
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13
Q

Muenster

Proximal Anatomical Self-
Suspending

A

Designed to provide a simplified prosthesis
for use with very short transradial limb
difference
* Emphasizes A-P soft tissue
compression
* Allows a larger M-L dimension to
contain displaced tissues
* suitable for congenital
applications with under-developed
bony contours

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14
Q

Muenster Casting - Hand Position

Proximal Anatomical Self-Suspending

A
  • Static cast with anterior brim 12 mm [1/2”]
    proximal to cubital fold
  • biceps tendon insertion emphasized by finger tips
  • Palm of hand cradles ulnar region gently
  • Triceps tendon region emphasized to improve axial loading in extension
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15
Q

Muenster Casting - Elbow ROM in Cast

Proximal Anatomical Self-Suspending

A
  • Limited ROM is expected: total of 70 deg flexion
    range, 35-105 degrees
  • Pre-flexion is commonly utilized to provide ROM for at least table-top activities
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16
Q

NU Supracondylar Design

Proximal Anatomical Self-Suspending

A
  • First reported by John Billock, CPO in 1972
  • Allows much greater ROM at elbow with “push in” donning
  • Suitable for much longer RL lengths than Muenster
  • Intended for use with emerging
  • EP controls but suitable for many prosthetic/orthotic applications
17
Q

NU Supracondylar - Casting

Proximal Anatomical Self-Suspending

A
  • Accurate measurements are CRITICAL!
  • Static cast, with elbow flexed 45 degrees
  • Intended for use with semi-flexible socket brim
18
Q

European [“Otto Bock”] Design

Proximal Anatomical Self-Suspending

A
  • Combo of Muenster and NU
  • less aggressive ML and AP control
  • muscle belly suspension (brachioradialis?)
  • Dynamic” impression method to capture full ROM at elbow
  • Suspension is most effective if pull-in donning is used to draw soft tissues into antecubital “displacement pocket”
19
Q

Sauter Modication

A
  • Removal of proximal/ulnar quadrant
    over olecranon
  • lowers friction, cooler, less bulky
20
Q

Brief Overview/Comparison

Proximal Anatomical Self-Suspending

A
  • Muenster - AP suspension; Very Short TR; congenital
  • OB - AP, ML, soft tissue suspension; Short to mid-length RLs
  • NU SC - ML suspension; Mid-length & longer RLs

ALL eliminate pronation/supination

21
Q

Wrist Disarticulations

Distal Anatomical Self-Suspending Socket Designs

A
  • Usually permit voluntary pronation/supination
  • Suprastyloid variants often successful for wrist disarticulation level
22
Q

Practitioner Reported % (of all UL Px)

TR/WD Control and Suspension

A
  • Harness - 42%
  • Suction - 10%
  • Lock/Lanyard - 14%
  • Seal-in - 4%
  • Vacuum - 0%
  • Self-Suspending - 24%

UL Px (13 decks)

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