If you have a friend or family member with an amputated limb, you might be curious as to how a prosthetic limb can stay attached to the wearer’s stump. Perhaps you’ve even asked. The answer is simple: a suspension system. When the prosthetic socket is created, there are two factors that they have to consider: the shape and construction of the socket as well as the system that secures the prosthetic to the limb. There is no one suspension system that can work for every prosthetic. Rather, the prosthetist will determine the system that will work best for each patient’s individual situation. Here are three types of suspension systems that they may consider:
The anatomic suspension system is used on the Patellar tendon-bearing socket. This method works with the help of anatomic structures to keep the prosthetics on. It is commonly used by amputees who have below-knee or knee disarticulation limbs. The below-knee prosthetic suspension, or Supracondylar suspension, has widened medial and lateral socket walls. It can fit snugly above and against the medial condyle. Other anatomic suspensions often use congenital protuberances when the residual limb is fully healed and will not be undergoing any more changes.
Strap, belt, and hinge suspensions
Strap, belt, and hinge suspensions can be considered old school systems. These suspensions are used when an anatomical suspension is not a possibility. The strap suspension comes with a waist belt. When the amputee puts it on, they can adjust the prosthetic easily. This is why a strap suspension is recommended for those who have had an amputation surgery due to the residual limb volume changes. For those with below-knee amputations, a suprapatellar cuff is an excellent choice because it surrounds the thigh and connects to the socket with straps.
This cuff is often used with a waist belt, but some patients can wear the cuff without the belt. In some cases, patients will be prescribed a thigh corset with metal side joints when their residual limb cannot take the weight-bearing load. Although a Silesian belt utilizes suction, there are other suspensions for those who can’t use it such as an elastic suspension belt as well as a hip joint and pelvic belt.
When it comes to suspension for upper-extremity prostheses, many methods can be used including suction, close fit around anatomy, liner, harness suspensions, and a combination of these. Harness suspension systems can be put on and taken off without any struggles. The downside, however, is that it can create a major restriction on an amputee’s range of motion. Many people also report experiencing discomfort due to the rubbing of the straps. Pure suction is a great suspension method since it does not need a harness for body control.
Gel liner is very functional for above-elbow and below-elbow systems. It is suitable for amputees who are highly active. For patients with short-to-medium transhumeral and transradial limbs, a pin and shuttle lock would be sufficient. This option is light, and the patient does not have to deal with a suspension sleeve with this option. In contrast, for long transradial and wrist disarticulation limbs, a lanyard system may be a better option. This works by connecting the liner to the socket with the help of a strap, ensuring that the prosthetic stays on without problems.
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