Fatone Stefania, Johnson William Brett, Tran Lilly, Tucker Kerice, Mowrer Christofer, Caldwell Ryan
1 Northwestern University Prosthetics-Orthotics Center, Northwestern University, Chicago, IL, USA.
2 Scheck & Siress Prosthetics, Orthotics, and Pedorthics, Oakbrook Terrace, IL, USA.
Prosthet Orthot Int. 2017 Jun;41(3):251-257. doi: 10.1177/0309364616684165. Epub 2017 Jan 17.
The fit and function of a prosthetic socket depend on the prosthetist's ability to design the socket's shape to distribute load comfortably over the residual limb. We recently developed a sub-ischial socket for persons with transfemoral amputation: the Northwestern University Flexible Sub-Ischial Vacuum Socket.
This study aimed to quantify the rectifications required to fit the Northwestern University Flexible Sub-Ischial Vacuum Socket to teach the technique to prosthetists as well as provide a computer-aided design-computer-aided manufacturing option.
Development project.
A program was used to align scans of unrectified and rectified negative molds and calculate shape change as a result of rectification. Averaged rectifications were used to create a socket template, which was shared with a central fabrication facility engaged in provision of Northwestern University Flexible Sub-Ischial Vacuum Sockets to early clinical adopters. Feedback regarding quality of fitting was obtained.
Rectification maps created from 30 cast pairs of successfully fit Northwestern University Flexible Sub-Ischial Vacuum Sockets confirmed that material was primarily removed from the positive mold in the proximal-lateral and posterior regions. The template was used to fabricate check sockets for 15 persons with transfemoral amputation. Feedback suggested that the template provided a reasonable initial fit with only minor adjustments.
Rectification maps and template were used to facilitate teaching and central fabrication of the Northwestern University Flexible Sub-Ischial Vacuum Socket. Minor issues with quality of initial fit achieved with the template may be due to inability to adjust the template to patient characteristics (e.g. tissue type, limb shape) and/or the degree to which it represented a fully mature version of the technique. Clinical relevance Rectification maps help communicate an important step in the fabrication of the Northwestern University Flexible Sub-Ischial Vacuum Socket facilitating dissemination of the technique, while the average template provides an alternative fabrication option via computer-aided design-computer-aided manufacturing and central fabrication.
假肢接受腔的适配性和功能取决于假肢师设计接受腔形状以便将负荷舒适地分布在残肢上的能力。我们最近为经股骨截肢者开发了一种坐骨下接受腔：西北大学柔性坐骨下真空接受腔。
本研究旨在量化使西北大学柔性坐骨下真空接受腔适配所需的矫正量，以便向假肢师传授该技术，并提供一种计算机辅助设计-计算机辅助制造选项。
开发项目。
使用一个程序来对齐未矫正和矫正后的阴模扫描图像，并计算矫正导致的形状变化。使用平均矫正量创建一个接受腔模板，并与一家为早期临床采用者提供西北大学柔性坐骨下真空接受腔的中央制造机构共享。获得了关于适配质量的反馈。
从30对成功适配的西北大学柔性坐骨下真空接受腔的铸型对创建的矫正图证实，材料主要从阳模的近端外侧和后部区域去除。该模板用于为15名经股骨截肢者制造检验接受腔。反馈表明，该模板只需进行少量调整就能提供合理的初始适配。
矫正图和模板用于促进西北大学柔性坐骨下真空接受腔的教学和中央制造。使用模板实现的初始适配质量存在的小问题可能是由于无法根据患者特征（如组织类型、肢体形状）调整模板和/或其代表该技术完全成熟版本的程度。临床意义矫正图有助于传达西北大学柔性坐骨下真空接受腔制造过程中的一个重要步骤，促进该技术的传播，而平均模板通过计算机辅助设计-计算机辅助制造和中央制造提供了一种替代制造选项。
