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Prosthetic sockets stabilized by alternating areas of tissue compression and release

This study introduces Compression/Release Stabilized (CRS) sockets, which feature longitudinal depressions in the socket walls with open release areas. The CRS sockets provide true control of the location of the underlying bone, leading to enhanced stability, comfort, energy efficiency, range of motion, and perceived weight for amputees.

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Prosthetic sockets stabilized by alternating areas of tissue compression and release

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  1. Prosthetic sockets stabilized by alternating areas of tissue compression and release Randall D. Alley, CP, LP; T. Walley Williams III, MA; Matthew J. Albuquerque, CPO; David E. Altobelli, MD

  2. Study Aim • Introduce compression/release stabilized (CRS) sockets (transradial, transfemoral, and transhumeral) created with longitudinal depressions in socket walls with open release areas between depressions that receive displaced tissue. • Relevance • True control of location of underlying bone of encapsulated limb has been largely absent since origin of prosthetic sockets.

  3. Reducing Lost Motion CRS CONVENTIONAL In CRS socket, 3 or more longitudinal depressions compress and displace tissue between socket wall and bone to reduce lost motion when bone is moved with respect to socket. Shown are 3 designs. (a) 2 depres-sions, only stable in 1 plane, but illustrates how compression/release works. (b) 3 and (c) 4 depressions, stable in all directions. (a) Cylindrical socket wall and humerus before force application. Dashed line = maximum compression. (b) Upward force applied, causing humerus to move upward with respect to wall until tissue is compressed. Most lost motion occurs before arm can cause socket to function usefully.

  4. Load Transfer CONVENTIONAL CRS Dashed line = level to which tissue must be compressed for load transfer. Conventional socket: (a) bone is centered before application of any load, but moves as shown in (b) when user moves humerus to flex arm. Action must compress tissue at both ends as shown. Only after bone has moved through substantial angle will socket pick up load, and all load is carried at ends. CRS socket: (c) tissue is already precompressed, so (d) load transfers almost immediately with little change in angle. Furthermore, load transfers along entire length of bone, not just at ends.

  5. Conclusions • CRS sockets are entirely new approach to interface design, focusing on controlling location of underlying bone with respect to socket or interface walls. • Sufficient patient fittings prove that CRS sockets offer enhanced stability, comfort, energy efficiency, range of motion, and perceived weight because they provide a better fit that allows increased functionality. • Further research must quantify how much pressure can be tolerated where socket approaches underlying bones.

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