Socket fit has the best impact on success in rehabilitation. There is a correlation between proper fit and perceived weight. Well-fitting sockets should have increased proprioceptive feedback, anatomical control, decreased energy expenditure, total contact and most of all, be comfortable. Socket fit determines the potential outcome, regardless of the components and efforts of the medical team.
poor fitting socket = poor gait = poor outcome
- Components will be unable to be used to the their full potential
- You will be unable to achieve goals
- Increased risk of damage to skin and joints
- Increased energy expenditure
Closely related to the design of the socket is the suspension, or how the socket remains in place on the limb. Suspension mechanisms are incorporated as part of socket design, and will be chosen prior to casting. Suspension can be achieved through a mechanical lock, suction, or capture of the anatomy. Mechanical lock is achieved by the incorporation of a pin or lanyard attached at the end of a roll-on liner which engages into a lock in the socket. Suction suspensions are achieved through a number of methods including seal-in liners and direct skin contact. Air may be evacuated via a pump to achieve elevated vacuum. Anatomical suspension is achieved when the contours of the socket capture and hold onto the contours of the limb. Each of these systems have advantages and disadvantages which will be discussed during your visit.