title: Comparison of transhumeral socket designs utilizing patient assessment and in vivo skeletal and socket motion tracking: a case study.
abstract: OBJECTIVE
  This case study compares the impact of two prosthetic socket designs, a "traditional" transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket.
  
  
  METHODS
  A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology).
  
  
  RESULTS
  Subjects were more satisfied with the comfort of the traditional sockets, although they had positive impressions about aspects of the fit and style of the CRS socket, and thought that it provided better control. Dynamic kinematic assessment revealed that the CRS socket provided better control of the residual limb within the socket, and had less slippage as compared to a traditional TH socket design.
  
  
  CONCLUSIONS
  The TH CRS socket provided better control of the residual limb within the socket, and had less slippage. However, participants were less satisfied with the comfort and overall utility of the CRS socket, and stated that additional fitting visits/modifications to the CRS socket were needed. It is possible that satisfaction with the CRS socket may have improved with prosthetic adjustment and more acclimation time. Implications for Rehabilitation A comfortable, good fitting prosthetic socket is the key factor in determining how long (or if) an upper limb amputee can tolerate wearing a prosthesis. This case series was a comparison of two socket designs, a 'traditional' socket design and a Compression Released Stabilized (CRS) socket design in persons with transhumeral amputation. The CRS socket provided better control of the residual limb within the socket, and had less slippage. However, its tightness made it more difficult to don. Both subjects were less satisfied with the comfort and overall utility of the CRS socket. However, satisfaction might have been improved with additional fitting visits and more acclimation time.
authors.affiliation: a Providence VA Medical Center , Providence , RI , USA .|b Departments of Health Services Policy and Practice , Brown University , Providence , RI , USA .
authors.forename: Linda
authors.initials: L
authors.lastname: Resnik
authors.affiliation: c Bioengineering Laboratory, Department of Orthopaedics , Warren Alpert Medical School of Brown University and Rhode Island Hospital , Providence , RI , USA , and.
authors.forename: Tarpit
authors.initials: T
authors.lastname: Patel
authors.affiliation: c Bioengineering Laboratory, Department of Orthopaedics , Warren Alpert Medical School of Brown University and Rhode Island Hospital , Providence , RI , USA , and.
authors.forename: Shane G
authors.initials: SG
authors.lastname: Cooney
authors.affiliation: c Bioengineering Laboratory, Department of Orthopaedics , Warren Alpert Medical School of Brown University and Rhode Island Hospital , Providence , RI , USA , and.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Crisco
authors.affiliation: d VA New York Harbor Healthcare System , New York , NY , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Fantini
mesh_terms: D000328:Adult; D000671:Amputation, Surgical / Q000534:rehabilitation*; D000672:Amputation Stumps; D000674:Amputees / Q000534:rehabilitation*; D001186:Artificial Limbs; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D009068:Movement; D017060:Patient Satisfaction; D011474:Prosthesis Design / Q000379:methods*
keywords: Amputation; biomechanics; evaluation; kinematic; motion; prosthesis; radiography; upper limb