Flexible-Socket Technology Applied to the Juvenile Above-Knee Amputee

DAVID J. JENDRZEJCZYK, CP**Newington, Connecticut

The Prosthetics Department at Newington Children's Hospital has been involved with flexible-socket technology since March 1984. Five above-knee amputees, aged 18 months to 15 years, were fitted with flexible sockets between June 1984 and January 1985.

All patients were fitted with quadrilateral total-contact sockets. The youngest was a new amputee who was fitted without suction. The others were previous prosthetic wearers and were converted from non-suction to suction sockets. Initially, donning the prostheses was a problem for young patients but, once educated, they unanimously preferred the flexible suction socket.

We have encountered two problems with the flexible-socket prosthesis. The first has been fracture of the strut at the anteromedial proximal brim in the adductor longus channel. Steps have been taken to correct the problem, including adding lateral support to the frame and changing the method of removing the cast after lamination. The second problem has been the cracking of the flexible socket. A thicker flexible socket, 0.08 in. or greater, eliminates the problem; however, we feel the ideal socket should not be more than 0.06 in. thick.

Even with the problems encountered, patient acceptance is high, with great enthusiasm for the new technology. Initial studies by Roy B. Davis, 111, PhD, of the Department of Engineering, Trinity College, Hartford, Connecticut, indicate that pressure is more evenly distributed in the flexible socket than in the rigid socket. His research confirms patients' feelings about the socket.

**Newington Children's Hospital, 181 East Cedar Street, Newington, CT 06111