Comparing Patient's Satisfaction with Socket Dimensional Measures in Three Casting Techniques for Below Knee Prosthesis

Below knee amputation, which is noticed as one of the most common lower extremity amputations, is caused as a result of various factors like trauma, disease, or congenital limb deficiencies. In order to take these amputees back to daily life, below knee prostheses are used as an alternate to original limb. Comfort and patients’ satisfaction with prostheses are directly related to each prosthesis socket, and socket composing design itself is associted with various casting techniques. The main objective of this study was to compare the patients’ satisfaction with sockets made by three casting techniques including weight-bearing, air-pressure, and elastic stockinet casting techniques. Other aims of this study were to detect the relationship between dimensional measures of three made sockets and patients’ satisfaction, to find out the effect of various casting techniques and socket dimensional changes on patients’ satisfaction and, finally, to offer correct techniques for optimizing the prosthesis making process. Ten, over 20-year-old below knee amputees with unilateral amputation who referred to technical orthopedic clinic at least one year after their amputation were selected in a nonrandom manner. Subsequently, casting was performed through three different techniques and positive casts were provided. Sockets made by lamination technique were then connected to other components made below knee prostheses by the help of which patients walked with and declared their level of satisfaction. In addition, positive casts were measured in order to be compared with each other. In descriptive statistics, including comparison between average dimensional casts measures and levels of satisfaction, variables showed significant differences. However, in analytical statistics, data were analysized via Pierson correlative statistical test. The relationship between distal anterior-posterior socket diameter and the level of patient satisfaction in weight-bearing casting technique was 0.58 which was so closed to 0.60 (the significant base of chart), but they had a converse relationship. Relation between socket volume and the level of satisfaction in weight-bearing technique, with 0.70, was conversely significant, and also in air-pressure technique, with 0.66, was directly significant. The relationship between socket height and level of satisfaction in air-pressure casting, with 0.69, was significant and direct. Despite low differences between levels of satisfaction in various casting techniques, air-pressure casting technique had higher level of satisfaction than the other two techniques. Based on the obtained hypotheses, patients were more satisfied with more voluminous and higher sockets.