A Workflow for Studying the Stump-Socket Interface in Persons with Transtibial Amputation through 3D Thermographic Mapping

The design and fitting of prosthetic sockets can significantly affect the acceptance of an artificial limb by persons with lower limb amputations. Clinical fitting is typically an iterative process, which requires patients' feedback and professional assessment. When feedback is unreliable due to the patient's physical or psychological conditions, quantitative measures can support decision-making. Specifically, monitoring the skin temperature of the residual limb can provide valuable information regarding unwanted mechanical stresses and reduced vascularization, which can lead to inflammation, skin sores and ulcerations. Multiple 2D images to examine a real-life 3D limb can be cumbersome and might only offer a partial assessment of critical areas. To overcome these issues, we developed a workflow for integrating thermographic information on the 3D scan of a residual limb, with intrinsic reconstruction quality measures. Specifically, workflow allows us to calculate a 3D thermal map of the skin of the stump at rest and after walking, and summarize this information with a single 3D differential map. The workflow was tested on a person with transtibial amputation, with a reconstruction accuracy lower than 3 mm, which is adequate for socket adaptation. We expect the workflow to improve socket acceptance and patients' quality of life

TOWARDS THE DEVELOPMENT OF BENCH TESTING FOR LOWER-LIMB PROSTHETIC SOCKETS FOR SPORT APPLICATIONS

Prosthetic sockets are the bespoken part of lower-limb prostheses. Knowledge about the mechanical properties of sockets is essential to ensure patient safety and comply with current medical device regulations. This includes sockets designed for sport activities. Unfortunately, the literature is extremely limited and contradictory as described in a recent systematic review. The aim of this study was to initiate a research activity aiming to design a mechanical bench system for socket testing and perform a comparative analysis of the ultimate strength of alternative socket layups. Results highlight substantial differences in the maximum loading at failure, stressing the importance of increasing the knowledge about socket mechanical properties to support prosthetists provide reliable and safe products to patients and athletes

Static strength of lower-limb prosthetic sockets: An exploratory study on the influence of stratigraphy, distal adapter and lamination resin

Knowledge about the mechanical properties of lower-limb prosthetic sockets fabricated with resin infusion lamination and composite materials is limited. Therefore, sockets can be subject to mechanical failure and overdimensioning, both of which can have severe consequences for patients. For this reason, an exploratory study was conducted to analyze the effect of stratigraphy (layup and fibers), matrix (resin) and mechanical connection (socket distal adapter) on socket static strength, with the objectives of: 1) implementing a mechanical testing system for lower-limb prosthetic sockets based on ISO 10328:2016 and provide the mechanical design of the loading plates, 2) apply the testing system to a series of laminated sockets, and 3) for each type of distal adapter, identify the combinations of stratigraphy and matrix with acceptable strength and minimum weight. Twenty-three laminated sockets were produced and tested. Sixteen met the required strength, with ten exhibiting an excessive weight. Among the remaining six, four combinations of stratigraphy and resin were identified as best option, as they all overcame ISO 10328 P6 loading level and weighted less than 600 g. The selected stratigraphies had limited or absent amount of Perlon stockinettes, which seems to increase weight without enhancing the mechanical strength. Sockets based on Ossur MSS braids and connector show the best compromise between strength and weight when the amount of carbon braids is halved