Preliminary Investigation Comparing Rectified and Unrectified Sockets for Transtibial Amputees

In Brief The current method for fabricating prosthetic sockets is to modify a positive mold to account for the nonhomogeneity of the residual limb to tolerate load (i.e., rectified socket). We tested unrectified sockets by retaining the shape of the residual limb, except for a distal end pad, using an alginate gel process during casting. This investigation compared rectified and unrectified sockets. Ten adults with unilateral transtibial amputations were tested after randomly wearing both rectified and unrectified sockets for 4 weeks. Testing included a gait analysis, energy expenditure, and Prosthesis Evaluation Questionnaire (PEQ). Results indicated no differences between sockets for gait speed and timing, gait kinematics and kinetics, gait energy expenditure, and rate of perceived exertion. There were no differences in the PEQ. Four subjects selected the rectified socket, and six selected the unrectified socket as exit sockets. The alginate gel method of fabricating the socket was simpler and less time-consuming than the traditional method. This method could be helpful in countries in which prosthetic care is lacking and may be helpful in typical clinics to reduce costs and free the prosthetist to focus more time on patient needs. Preliminary results indicate that more than one paradigm may exist for shaping sockets. Understanding the mechanisms for these paradigms could lead to customizing the socket to better meet the varying needs of individual patients. This article compares test results for two types of prosthetic sockets; rectified and unrectified. The rectified method is the traditional and currently favored mode of socket fabrication. However, user test results indicated no differences between the two methods in several key areas of evaluation.