The socket is the part of the prosthesis which is contact with the residual limb. It allows the various components to be mounted to the prosthesis including harnessing, elbows, wrists, terminal devices, etc.

Transfemoral Preparatory Prosthesis is a rigid co-poly plastic socket that is made from a model of the limb. This is usually done 3-5 days after the surgery. This is a device that is worn with compression and prosthetic socks which will allow a patient to begin gait training soon after surgery. This device has a waist belt for suspension, a manual-locking knee, a pylon and a single-axis foot. This device is usually prescribed for those patients who are more mobile and able to utilize the prosthesis soon after surgery

ForequarterShoulder DisarticulationTranshumeral (AE)Elbow DisarticulationTransradial (BE)Wrist DisarticulationPartial HandFingers

This type of prosthesis can be used for all levels of amputation. It is used primarily to replace the body part that is missing. This promotes a healthy body image, and is also functional. For instance, a passive artificial hand can be used to hold or place objects.

This prosthesis uses body movements to operate the terminal device (artificial hand or hook.) The prosthesis is connected to the body through the use of cables and harness. Using movements of the shoulders and the arms, the person can open and close the terminal device.

The Myoelectric uses signals from muscles of the residual limb to control the opening and closing of the terminal device (hook or hand) or elbow depending on the level of amputation. Electrodes are incorporated into the prosthetic socket and by contracting the muscles of the residual limb, electrical signals are sent to the motors which open and close the terminal device (hook or hand) or lift and lower the forearm at the elbow.

A harness holds the device to the body so the prosthesis can be used properly. When using a body powered prosthesis, the harness is used to open or close the terminal device. Depending on the level of amputation it may also be used to lock and unlock an elbow. The harness can be worn over an undershirt to help minimize the friction between the harness and the skin. This will also help keep the harness clean.

This part of the prosthesis allows extension and flexion of the forearm. Body powered elbows are flexed using a cable connected to the harness or by lifting and locking them with the sound limb. Electronic elbows are also available for use with myoelectric prosthetics which uses bionic technology to function.

Terminal Devices There are three main types of terminal devices for the upper limb prosthesis: hands, hooks and specialized terminal devices.

Hands can be either passive (non-functional) or functional. Functional hands can be either body powered or myoelectric.

Specialized terminal devices are customized for a sport, hobby, or profession. You could have a baseball mitt attached to the wrist or a poolsnooker rest.

Prosthetic feet are categorized by levels of activity; this means how well you ambulate (walk). Examples are: if you walk with an assistive device (walker or cane), if you walk in varying speeds, or if you lead an active lifestyle and participate in sports or other recreational activities. The type of foot that is prescribed will vary. Other factors that determine the type of foot that is chosen are your body weight, if you walk on uneven surfaces, the type of job you have and the length of your residual limb.

Compression or AKBK Shrinkers are used to control edema and shape the limb. Compression is used in all post-operative devices but is also used alone in some cases. This is the minimal amount of post-operative management you may receive. Shrinkers may be in the form of an open-ended tube which is rolled onto your limb and then reflected at the bottom of your limb for a second layer or a single layer sock that is stitched at the bottom. Either way it is important that you pull the sock snug to the bottom of your limb to reduce the chance of swelling.

There are many types of wrist units that offer the user the ability to rotate his or her terminal device to any position, offer a quick disconnect of the terminal device to easily change between a hook or hand or any other type of terminal device, and also units that allow for flexion and extension of the terminal device at the wrist.

A clear plastic check socket is made from the model; this is what the prosthetist will use for initial fitting. The check socket allows the porsthetist to make changes to the fit of the prosthesis or to change the alignment as you begin to walk. The check socket is typically utilized for one or two weeks while beginning therapy. Your prosthetist will follow-up with you as well as your therapist to ensure the fit and the function of you prosthesis is optimal and to address any issues immediately. As you become stronger, more flexible and confident on the prosthesis, your gait (the way you walk) will change and therefore your prosthetist will need to make changes to your alignment. Your check socket will consist of a clear socket, means of suspension, knee, pylon and a foot. The components are used in your prosthesis are determined by your prosthetist.

Immediate Post-Operative Dressing is placed on your limb in the operating room immediately after surgery. The purpose of this dressing is for mild protection of the limb; keep any post-operative swelling under control and to allow for inspection of the incision. The surgeons initial dressing may vary and could be either a sterile post operative sock or an ace wrap bandage, both of which are wrapped over sterile dressing.

Prosthetic knees today offer many different options for amputees of all levels. Depending on your level of activity and specific circumstances, your prosthetist will choose a knee that will provide you with what is most appropriate. A Manual Locking Knee is the most stable type of knee available. A Single-Axis, Constant Friction Knee is simple, inexpensive and lightweight. A Single-Axis, Constant Friction Knee with Stance Control has a breaking feature that prevents the knee from buckling when weight is put on the leg. A Single-Axis, Fluid Friction Knee varies its resistance as walking speed varies or when running. A Polycentric Knee is a very stable knee that allows for very fluid walking. A Microprocessor Knee is a computerized knee that responds automatically to the walking patterns of the patient and has added stability.

There are many ways to suspend a prosthesis. Some of the more common techniques are as follows: Supracondylar suspension which is suspension above the bony anatomy of the knee. Silicone suspension uses a liner that is rolled onto the limb which has a pin attached into a lock into a mechanism inside the prosthesis. Seal-in suction is also a liner that is rolled onto the limb but this design has a sealing ring, or rings, that seal against the walls of the prosthesis. Vacuum suspension is another technique that uses the TSB socket design (for below knee-amputees) and vacuum pump to mechanically hold the prosthesis on the limb with suction. This design provides excellent adhesion and improved wearer comfort.

A rigid removable dressing or protector as it is commonly called may be used initially after surgery or once the series of rigid casts have been utilized. This is approximately 4 weeks post-operative. The purpose of this device is to control edema, protect, and shape the limb for future prosthetic fittings. This device is removed several times per day and the fit is modified with prosthetic socks. This device is used until the artificial leg is being worn consistently. Flotech is another type of protector that has similar qualities as the rigid cast and the removable dressing. This is not a custom protector like the other styles but does offer some protection from accidental bumps. Compression and prosthetic socks are utilized with this device as well.