Note: This text is a work in progress. If you find any inaccuracies or material that needs to be included, please contact us.
Background
The most essential part of any prosthesis is its attachment to the body. The fit must be comfortable enough to wear the prosthesis all day with minimum discomfort, and for a functional prosthesis it must also be rigid enough to transfer force from the body to an object that is being grasped, lifted, or leaned upon. Often these two requirements compete with one another, because a prosthesis that fits more tightly for a strong connection is also likely to be less comfortable. The consequences of a bad fit can be skin irritation, pain, and even tissue breakdown.
The system used to attach a prosthesis is called a suspension system. There are several types of suspension systems currently in use, and the choice of which to use is often based on the specifics of the user’s residual limb and lifestyle. The following general methods are common:
- Adjustable sleeve: This type of suspension achieves proper fit through user adjustment of a strap or buckle. It is often used temporarily while the user’s stump is changing shape or volume or if other suspensions are unsuitable. The silesian belt for artificial legs is an example of this method.
- Elastic sleeve: An elastic sleeve is an stretchy tube lined with frictionate material that grips the user’s stump with a combination of friction and vacuum. These are usually made of silicone with a fabric layer on the outside for easier handling. Silicone gel is often incorporated for a softer and more comfortable interface.
- Suction socket: A suction socket attaches by creating a vacuum between the stump and the prosthesis. As the patient dons the prosthesis, air is expelled from the socket through a one-way valve. The negative pressure around the stump holds the prosthesis in place until the user releases it by opening the valve. Here is an example of a suction socket that uses an impermeable mebrane between stump and vacuum.
Resources
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