socket variation 2(ICS)_2015.pptx prosthetic

Different types of sockets

1. Socket V ariat i on (I C S) T ransfemoral P r osthetics By Saad Saleem Adapted from Lectures of Sas a ki Kazuhi k o

2. O b ject i v es A t the end of this s e s s ion, the participants a r e ab l e t o e xpla i n the di f f e r enc e s b e t w e e n QL soc k e t and • Ischi a l C o n t ainm e n t S oc k e t ( I C S ) de s ig n .

3. Co n t e n ts • D e v elopme n t of isch i al c o nt ainm e n t ( I C S ) de s ign soc k e t • The pr i nc i ple o f i s ch i al c o nt a i nm e n t soc k e t ( I C S ) de s ign I n t r oduct i on of t he M a r lo An a t omi c al S oc k e t ( M . A .S.) de s ign •

4. T ransi t ion to I schial C ontain m ent D esign © S T A A T S - C SUD H - 2000 Qu a d r i Lat er al 1970 ICS Plug Fit 1930-40 ’ s P r e - Qu ad 1950

5. V ariations of Ischial Contain m ent Shapes Socket J. Sabolich MAS 2004 5 IPOS 1990 CSUDH 2000 C A T -CAM 1985 NSNA A. Long 1974 UCLA C A T - CAM 1985

6. Quadrilateral socket with narrow A - P and wide M -L lacks lateral stabilit y . M - L M- L

7. How about lat e ral s t ab i l i ty of socke t ？ 1 . A b du cti o n o f f e m u r G e t s o r e a t t h e en d o f f e m u r 2 . pe l v is s h i f ts m ed ially G e t s o r e a t t h e p r o x im a l m eda l w a l l quadr i la t er a l a b d u c t or gap 3. Create a g ap at the proxi m al lateral w all A b d u c t ion of g e t s ore F e mur 4 . La x ity o f abdu ct o r m u scle 5 . lat e r a l tru n k bend ing ( A b no r m a l g a i t ) Stance p hase L a t e r a l t runk 5 b e n d ing L ax i t y of 4 2 mu sc le 3 A b d u c t ion 1 g e t s ore

8. ( Ｍ－Ｌ loc k ) tissue M - L Secure m ent of lateral stability lock ＝ skelet a l M - L ＋ M- L soft greater trochanter Soft tissue M - L Skele t al M- L Conce p t of th r e e - point fixation & M - L lock Sup e rior part of greater Skeletal M-L Bony lock Soft tissue M-L Counter force

9. N o rm a l Shape N o rmal Alignment N.S.N.A. ( Ivan L o ng) Mo s t a b o v e kn e e a m pu t e e s w a l k s with a wide ba s e and lu r ch t o t he ampu t a t ed s i de. L M N. S .N . A. 91% of qu a dr i la t e r al so c k e t u s e r s h a v e f emo r al abdu c t i on in s ide the soc k e t. (Lo n g. I. A , No rm a l s h a p e - no rm a l alig n ment (NS N A) abo v e - k n ee p r o s t h esis, Clin. P r o s t h e t . Or tho t . 9, 1 9 8 5 , P 9 ~ 1 4 ) L o ng ’ s Line

10. CAT-CAM （ S a bolich) Con t oured Controll e d A d ducted Ali g n m ent Trochanteric M e thod S a b o l i c U C LA NS N A QL

11. The U C LA te c hnique I ntro d uced to Japan b y Mr. Ch r is to p her Hoyt, a l ec t urer o f UCLA in M a r ch, 1 991

12. D i ffe r ence b e tween q u a d r i la t eral （ Q L ) socket & Ischial Ra m us Con t ain m ent （ I C ) s ocket

13. QL Vs IC S

14. QL IC S

15. QL （ ante r i or ） IC S

16. IT le v el QL ( pos t e r io r ） IC S

17. M - L Sk e le ta l S k e l et a l M- L

18. S o ft tissue M - L

19. Con f igu r a t ion d i f ference b e tween QL sock e t & ICS at top A l evel Rectus f e m oris Ad d uct o r lo n gus f e m ur M L Glu t eus m axi m us P

20. Design of is c hial conta i n m ent a r ea A i n t e rsec t i o n M f e m ur L P

21. 包み込む 高 さ Intersection area & height of encapsulating part S a boli c h U C LA NSNA QL c lea r a n c e 5 ～ 10 ㎜ inte rsec tion

22. M - L lock QL s o cket I C s o cket

23. Static a lignment tilt ４ ° medi a lly ４ °

24. Shape L i ne

25. Probl e m s of qu a dri l a t er a l sock e t ◇ insu f ficient sta b ility ◇ likely p r essure pain in di r ecti o n ◇ h i - i m pact on ◇ likely p r essu r e p a in on w hile seat e d

26. Advantages of ischial containment socket stability ・ N o p r e ssu r e p a in in di r ection due to w ide A- P ・ sm a ll imp a ct on on p r o sthesis w hile w eigh t ed ・ small p r essure pain on ha m string w hile seated ischial tub e r o sity A- P Excellent late r al

27. Princip l es of t h e IC soc k e t M r . Pr i t h a m de s cr i bed s i x object i v es that w ould be a ch i e v ed in the id e al i s ch i al c o n t a i nm e n t soc k e t: (Pri t h am C. H . , B i o m e c h a n i c s a n d S h a p e o f t h e A b o v e - K n ee S o c k e t in Lig h t o f t h e I sc h ial C o n t ai n me n t C o n c e pt , P r o s t h e t . Or th o t . I n t er n a t io n al. 1 4 , 1 9 9 , P 9 ~ 2 1) 1. M a i n t en a nce of n o rm a l f emo r al addu c t i on and nar r o w -ba s ed g ait during a m bulation

28. Princip l es of t h e IC soc k e t 2 . En c losu r e of the i s chi a l tube r osi t y and r a m us in the soc k e t f o r c e s i n v ol v ed in mai n t en a nce of medio la t e r al st ab i li t y the a r e borne b y the bones of pelvis med i a l ly “ Bo n y Loc k ”

29. Princip l es of t h e IC soc k e t 3. M a ximum e f f ort made t o di s tr i bu t e f o r c e s a l ong the shaft of the f emur with hip addu c t i on

30. Princip l es of t h e IC soc k e t Dec r e a s e d emph a s i s on a nar r o w AP diame t er b e t w e e n the addu c t or lon g u s - S c a r pa ’ s t r i a ngle 4 . and i s ch i um f or the ma i n t en a nce of is c hi a l - glu t e a l w eig h t be a ring 5 . T o t al c o nt a c t 6 . U s e of su c t i on su s pen s ion when e v er p o s s ible

31. Ad v anced S oc k e t Design

32. Ad v anc e d Soc k e t Des i gn The Ma r lo An a t omi c al S oc k e t Design (M . A .S.), d e v eloped b y Ma r lo Ortiz

33. The Marlo An at omi c al Soc k e t (M . A .S . ) • • • • • Imp r o v e func t ional g ait B e tt er su s pen s ion Enhan c ed c osm e s i s D o nning and do f fing Un r e s tr i c t ed r an g e of m o t i on

34. R e f e r enc e s Douglas, T r an s f emo r al Amp u t a tion: • P r o s t h e tic a n d L imb ma n a g e m ent, A tlas of Am p u t a tio n s D e fic i e n c i es ,2004 • F i tzl a f f , L o w er Limb P r o s t h e tic C o m p o n ents, Desig n , Fu n ct i on and B i omec h ani c al P r o p e r tie s ,2002 ( P ritham C. H., B i omec h anics and Shape of the A b o v e - K n ee Soc k e t in Lig h t of t h e I sc h ial C o n t ainment C on ce p t, P r o s t h e t . Ort h ot. I n t e r n a tio n al. 14, 1 990, P9~21) •