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Heather Mills - Amputee Forum
Omppu

Socket question

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Hi all, I have written here 8 years ago and have something to ask again.

So I have new leg and new socket. It's different from my old leg.

My old leg was like this http://rinko.com/quadrilateral-ischial-containment-qic-socket/.

Now my leg man didn't let the soft inner socket to bee longer, it's now same hight than my hard outer socket.

My leg man says it's been left longer in the photos because it sells better and that there's actually any benefits to left longer

Can you please tell me if you have socket like this, have your leg man left the inner socket longer?

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Actually the socket in that link is not exactly like my old socket. I only want to know is it really so that there is no benefits when the inner socket is longer than the outer socket.

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My inner liner has always been cut down...it's only a tiny bit longer than my outer socket, just enough to add alittle bit of padding at my knee. However, I'm a below-knee amputee, and that socket looks like you're above-knee. Maybe one of our AKs can chime in here....??

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Hi Omppu,

My socket looks like the one in the picture. I would not wear mine with the inner and the outer cut to the same length. It would cause pinching, which happens if you aren't entirely into the socket properly, but even if you are, I would not feel comfortable and happy to completely relax knowing I might get pinched at any time. If any amount of skin or tissue finds it's way out of the inner, it will find it's way between the inner and the outer, and that hurts!

I would ask for the outer to be trimmed a little, if they haven't gone too far already.

Also... it can be more comfortable if the inner can flex a little around the trim line...

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The outer socket must be lower than the inner socket, if you are using one like the one in the picture. The inner socket is designed to be higher for comfort and also for some stability.

Ask your leg-man what type of socket you have. If it is a MAS or an Ischial Containment (IS) socket, then you are right to be asking why the inner socket is not longer than the outer socket. It doesn't sound right to me......

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I've had around 20 sockets manufactured in the last ten years and in that time every single one has had the inner socket a little longer than the outer.

The reason of this is that the two components are doing different jobs.

The inner interfaces with you (the wearer) and is made of a flexible (to some degree) material to cope with changes in stump shape during normal use. The top of the socket is cut to suit your body, the ends are normally flared (curved) to make it more comfortable.

The outer is the support frame, it is purely structural and designed to transfer the forces from your body through to your prosthesis. It is quite common to have windows cut into the outer socket in order to make sitting more comfortable, relieve pain in problem areas (such as a point in the stump where the muscle is rolling over the bone) or even to reduce weight. Depending on the materials used the outer socket can be very minimal, have a look at the ISNY socket, its no different to a standard ischial containment socket other than the frame has been reduced in size as much as possible.

It sounds like your prosthetist is making a socket that is perhaps beyond their current skill set, something that is sadly far too common. I experienced it myself with a prosthetist making five sockets before finally saying (in passing) that he didn't really make that type of socket very often and wasn't very experienced in doing so. Once I asked why he was doing work that was "out of his scope of practice" he stopped wasting my time and found a colleague that was correctly trained to make me a socket.

A good socket is comfortable to wear all day long, you should be able to put it on in the morning, go about your day as normal and take it off when you're done for the day. Whilst not regularly I have, on many occasions, worn my prosthesis for longer than 48 hours covering a days use, 24 hours of flying, several hours waiting in an airport before finally arriving at my destination just in time to start a days work. It's not a good idea to do this but it should be possible and if your socket has been made correctly it is.

Good luck getting your leg sorted and let us know how you get on.

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