Evaluating modified socket casting and molding vs. total surface bearing techniques in unilateral transtibial...

To achieve functional and comfortable prostheses, great attention must be paid to socket design, as it represents a critical interface between the residual limb and the prosthetic limb. This study aimed to evaluate the outcomes of unilateral transtibial amputees utilizing modified socket casting/molding technique in comparison to total surface bearing (TSB) socket.

Eight individuals with unilateral transtibial amputation participated in this cross-over design trial. Each participant used both the TSB and modified socket casting/molding designs. Four weeks after the utilization of each socket, the assessment was conducted on socket fit satisfaction (measured through the Comprehensive Lower Limb Amputee Socket Survey), socket rotation (evaluated using a standard meter), socket/liner interface pressure (monitored with 10 force-sensitive resistors), and the amputees' decision regarding the retention of one of the sockets after the trials (gauged via a numerical rating scale).

The amputees experienced greater stability ( P = 0.02) and improved lateral rotational control ( P = 0.01) during prosthetic gait when using the modified socket, compared with the TSB socket. Local pressure on the anterodistal tibia and the head of the fibula was not statistically significant ( P > 0.05) between 2 socket types. The decision of participants to retain the modified socket was significantly higher than that for the TSB socket after the trial period ( P = 0.03).

The modified socket design may offer advantages by providing improved rotational control during walking and reducing local pressure on the anterodistal tibia and fibula head. In addition, it maintains the total surface contact concept.