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Updated: Jan 13, 2026

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PACT: A practice-driven predictive algorithm for customized transradial prosthetic socket design.

Vishal Pendse1,2, Calvin C Ngan2, Elaine Ouellette2

  • 1Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.

Plos One
|January 8, 2026
PubMed
Summary
This summary is machine-generated.

The Predictive Algorithm for Customized Transradial Socket Design (PACT) rapidly creates prosthetic sockets from 3D limb scans. This automated approach offers a viable alternative to traditional methods, improving efficiency in prosthetic care.

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Area of Science:

  • Biomedical Engineering
  • Prosthetics and Orthotics
  • Computer-Aided Design

Background:

  • Standardized digital socket design for upper-limb prosthetics is lacking, requiring significant clinician time.
  • Current methods for prosthetic socket design are not fully optimized for efficiency and patient-specific fit.

Purpose of the Study:

  • To introduce and validate the Predictive Algorithm for Customized Transradial Socket Design (PACT) for generating transradial prosthetic sockets.
  • To assess the accuracy and efficiency of PACT compared to traditional prosthetist-designed sockets.

Main Methods:

  • PACT utilizes a reference library and scaling adjustments (isotropic and anisotropic) on 3D limb scans to generate socket models.
  • Validation involved comparing PACT-generated sockets with prosthetist-designed sockets (gold standard) using surface distance, volume difference, and cross-sectional area analysis for 19 participants.
  • Localized discrepancies were identified using signed-distance colorization and DBSCAN clustering.

Main Results:

  • PACT-generated sockets showed an average surface difference of 2.11 ± 0.51 mm and a volume difference of 2.74 ± 2.56% compared to prosthetist designs.
  • Slice-wise area differences were mostly within ±10%, with larger deviations near the socket's proximal and distal ends.
  • Common discrepancies included the anterior-distal trimline and anterior-posterior compression, with age-related sizing biases observed.

Conclusions:

  • PACT rapidly produces a first-draft transradial socket within clinical fit tolerances (average time: 13.2 ± 0.7 s).
  • Identified discrepancies provide targets for future algorithm refinement, incorporating factors like tissue stiffness and age.
  • Further personalization and generalizability can be achieved by integrating regional data and clinician measurements.