Prosthetics open up new possibilities for upper and lower-limb amputees. However, the fitting of prosthetic devices is complex. Many amputees are eager to get their prosthetic legs or arms right away, but it doesn't quite work like that.
Fitting a prosthetic socket comprises two phases: the temporary or preparatory prosthesis and the final or definitive socket. That's because even after your custom prosthetic is made, your prosthetist may need to change the shape of the socket, liner thickness, or type of suspension system used as you adapt to using your device.
We detail below what you can expect during an amputation prosthesis fitting and how to ensure it's as pleasant as possible. And if you need a custom prosthetic socket in Albuquerque & Las Cruces, call our dedicated team at PrimeCare!
What Is a Prosthetic Socket?
A socket is an interface between a residual limb (stump) and a prosthetic device. This custom-made sleeve fits snugly around the end of the residual limb. It creates a suction seal that allows the prosthesis to distribute an amputee's weight and facilitates fluid, comfortable movement.
Sockets are custom-made to fit the individual amputee's residual limb and may have various features to provide support, stability, and comfort.
Some of the most common features of prosthetic sockets include:
- A suction seal: This helps to create a secure fit between the socket and the residual limb.
- A liner: This is a soft, cushioned layer that distributes pressure and reduces friction.
- A suspension system: This keeps the prosthesis in place and prevents too much socket rotation and slippage.
- Adjustment features: These features allow the prosthetist to make fine-tuning adjustments to the socket fit.
The Importance of a Good Amputee Socket Fitting
The correct amputee socket fitting is essential for the comfort and function of prosthetic legs and arms. Adjusting the fit of a prosthesis to the correct level of comfort is vital for the following:
- Comfort: The right socket reduces pressure and friction on the residual limb, preventing pain and discomfort, which is essential for those with sensitive skin or prone to developing pressure sores.
- Functionality: A snug socket allows amputees to use their prostheses effectively and comfortably, making walking, running, and participating in activities easier.
- Confidence: A well-fitted socket ensures amputees feel confident and independent, improving their quality of life.
If you are an amputee, it is essential to work with a qualified prosthetist to ensure that you have a well-fitted, weight-bearing socket. They will rectify any prosthesis fit issues to achieve the best possible results from your prosthetic device.
The Prosthesis Fitting Process — What to Expect
We're often asked, "When is a prosthesis fitted after amputation?".
Regardless of whether it's an above-the-knee or a below-knee amputation prosthesis fitting, the process for a new amputee only begins after the swelling in the residual limb has subsided, and the suture line has healed, which usually takes four to six weeks after surgery.
General things you can expect during the fitting process:
- Your physician will prescribe a prosthesis once the limb has healed. They and your insurance company (or other payers) will determine the timing of the fitting.
- As a prosthetic user, your prosthetist will discuss your rehabilitation goals and expectations for everyday life, so they can customize your device to fit your lifestyle and daily needs.
The fitting process can take several weeks or even months, as your prosthetist will need to adjust the socket and other components as your residual limb changes shape and size. Be patient and work closely with your prosthetist to ensure you have a well-fitting prosthesis that meets your needs.
— Fitting the Temporary Socket
The next step in the fitting process is creating a temporary socket. New amputees receive a temporary prosthesis for a few months as their residual limb continues to reduce in size and mature.
However, those who have worn a prosthesis before have a much shorter fitting process - a few days to a few weeks.
Below are some of the things you can expect during this stage of the prosthetic socket fitting process:
- Your prosthetist will create test sockets to see how your residual limb responds to them.
- Other components are added as you start to stand and walk or use your arm and hand. The temporary prosthesis does not usually have a cosmetic covering, as adjustments will need to be made continually as the residual limb decreases in size.
- Physical therapy is an integral part of your recovery and rehabilitation process. Your physical therapist will design a rehabilitation plan that suits your lifestyle goals. Some people may also need to have occupational therapy.
Remember that the temporary prosthesis may not be perfect, but it will allow you to start using your prosthesis and regain your independence.
As your residual limb changes shape and size, your prosthetist will adjust the prosthetic design. At PrimeCare, we monitor your progress with an app that provides important data for the final fitting.
Eventually, you will have a permanent prosthesis that meets your needs.
— Fitting the Final (Definitive) Prosthesis
The final stage of the fitting process is the definitive prosthesis. This is the permanent prosthesis you will use long-term.
Your prosthetist determines the timing of casting for the definitive prosthesis. For new amputees, it is usually done several months after surgery to allow the residual limb to heal and stabilize in size and shape. However, experienced prosthetic users may undergo casting more quickly as they are accustomed to the process and adjustments.
Here are some of the things you can expect during this stage of the fitting process:
- Your prosthetist will create a final custom socket and attach all other prosthesis components to it.
- There will be options for a cosmetic covering.
- The creation and fitting of the definitive prosthesis will require several visits and can take a few weeks to complete.
The terms "final" or "definitive" prosthesis are not necessarily absolute, meaning no prosthetic leg or arm will last forever. A prosthesis can last anywhere from two to five years, depending on daily usage and activity level.
In some cases, the prosthesis may need repairs. At other times, only single components may require replacement rather than creating an entirely new prosthesis.
Tips for Fitting a Prosthesis Socket
It's normal for your residual limb volume to fluctuate during rehabilitation. To prevent pain and discomfort and improve the fit of your prosthesis, you should:
— Get the Right Liner
If your socket is too loose, switch to a thicker liner to create a snug fit and reduce the amount of movement within the socket. You may also need to reduce the number of plies (layers of fabric) in your prosthetic sock.
If your socket is too tight, switch to a thinner liner to reduce the pressure on your residual limb. You may also need to add a thin sock to take up extra volume within the socket.
Some specific recommendations:
- If you have an above-the-knee prosthetic, switch to a 9mm liner, and reduce the number of plies in your prosthetic sock by 10-15. This usually helps knee amputees manage any rotation they may have been experiencing in their prosthetic leg.
- If you have a below-the-knee prosthetic, switching to a 9mm liner can make it easier to bend your knee, as the liner still features a 3mm thickness in the back, which avoids knee flexion restrictions.
It is important to note that these are just general recommendations. The best way to determine which liner thickness is right for you is to consult your prosthetist. They will be able to assess your needs and make a recommendation based on your situation.
— Consider a Gel Sheath
Consider using a gel sheath or sock if your prosthetic socket feels loose. You can wear this thin, flexible sleeve over or under your prosthetic liner.
Here's how a gel sheath can improve your prosthetic fit:
- Increases cushioning: Extra cushioning between the liner and the residual limb reduces pressure and prevents skin irritation.
- Reduces friction: A gel sheath reduces friction between the liner and the residual limb, which prevents the liner from slipping or bunching up.
- Improves suspension: Better suspension creates a more snug fit between the liner and residual limb.
- Absorbs moisture: Moisture absorption prevents skin irritation and keeps the limb cool and dry.
- Customized fit: Customization ensures a comfortable and functional fit.
Talk to your prosthetist to determine if a gel sheath suits you.
Securing an Optimal Socket Fit with Prime Care
If you're a new amputee, it is important to be patient during the fitting process, as it may take some time to find the perfect fit. We understand this can be frustrating. However, the benefits of a well-fitting socket are worth the wait. With a comfortable and functional socket, you can regain your independence and enjoy a full and active life.
If you need a custom-fit prosthesis, contact PrimeCare now for an expert prosthetic fitting. Our dedicated team has helped many happy patients in Las Cruces & Albuquerque improve their quality of life.