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基于假肢接受腔与残肢之间的界面压力的义肢接受腔的优化设计和 3D 打印。

Optimal design and 3D printing of prosthetic socket based on the interface pressure between the socket and residual limb.

机构信息

Tribology Research Institute, Key Laboratory for Advanced Technology of Ministry of Education, Southwest Jiaotong University, Chengdu, People's Republic of China.

Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Chengdu, People's Republic of China.

出版信息

Prosthet Orthot Int. 2023 Feb 1;47(1):87-93. doi: 10.1097/PXR.0000000000000147. Epub 2022 May 4.

Abstract

BACKGROUND

At present, the quantifiable pressure distribution at the interface between the socket and stump is seldom applied in the design and fabrication of the socket.

OBJECTIVES

This study aimed to optimize the socket based on the interface pressure of residual limb-socket, thereby avoiding excessive local load on the residual limb, reducing the load on the pressure-sensitive (PS) regions and making the limb more evenly loaded.

METHODS

The residual limb was divided into the main load-bearing regions, the pressure-tolerant regions, and the PS regions according to the carrying capacity at its different regions. Based on these bearing regions, a mathematical function was developed, which applied modifications/adjustments to the socket design in a Computer Aided Design (CAD) environment by using the adjustment function. Besides, three adjusted sockets were produced by using selective laser sintering 3D printing technology.

RESULTS

The wearing of the 3D-adjusted printed sockets reduced the contact interface pressures in the distal tibial region and the fibular head region by 85.6% and 84.4%, respectively. In addition, the walking distance of the subject was increased by 18.34%, and the overall pressure distribution on the stump became more uniform.

CONCLUSIONS

The pressures in the original overpressure regions and the PS regions could reduce, whereas the pressure in the low-load regions of main load-bearing or pressure-tolerant regions could increase by modifying the socket with the pressure adjustment function. At the same time, the pressure among different regions was more uniform except for the sensitive regions.

摘要

背景

目前,在义肢接受腔的设计和制造中很少应用能定量测量接受腔与残肢界面之间压力分布的方法。

目的

本研究旨在基于残肢-接受腔界面压力来优化接受腔,从而避免残肢局部承受过大的负荷,减少对压力敏感(PS)区域的负荷,使残肢承受的负荷更加均匀。

方法

根据不同区域的承载能力,将残肢分为主要承重区域、耐压区域和 PS 区域。在此基础上,开发了一个数学函数,通过使用调整函数在计算机辅助设计(CAD)环境中对接受腔设计进行修改/调整。此外,还使用选择性激光烧结 3D 打印技术制作了三个调整后的接受腔。

结果

3D 调整打印接受腔的佩戴降低了胫骨远端区域和腓骨头区域的接触界面压力,分别降低了 85.6%和 84.4%。此外,受试者的行走距离增加了 18.34%,残肢的整体压力分布更加均匀。

结论

通过使用压力调整功能修改接受腔,可以降低原始过压区域和 PS 区域的压力,同时增加主要承重或耐压区域的低负荷区域的压力。同时,除了敏感区域外,不同区域之间的压力更加均匀。

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