Editing Prosthesis (section)

=== Production of prosthetic socket ===
The production of a prosthetic socket begins with capturing the geometry of the residual limb; this process is called shape capture. The goal of this process is to create an accurate representation of the residual limb, which is critical to achieve good socket fit.<ref name=":6">{{Cite journal|last1=Suyi Yang|first1=Eddie|last2=Aslani|first2=Navid|last3=McGarry|first3=Anthony|date=October 2019|title=Influences and trends of various shape-capture methods on outcomes in trans-tibial prosthetics: A systematic review|url=https://pubmed.ncbi.nlm.nih.gov/31364475/|journal=Prosthetics and Orthotics International|volume=43|issue=5|pages=540–555|doi=10.1177/0309364619865424|issn=1746-1553|pmid=31364475|s2cid=198999869}}</ref> The custom socket is created by taking a plaster cast of the residual limb or, more commonly today, of the liner worn over their residual limb, and then making a mold from the plaster cast. The commonly used compound is called Plaster of Paris.<ref>{{Cite journal|last1=Sharma|first1=Hemant|last2=Prabu|first2=Dhanasekara|date=September 2013|title=Plaster of Paris: Past, present and future|journal=Journal of Clinical Orthopaedics and Trauma|volume=4|issue=3|pages=107–109|doi=10.1016/j.jcot.2013.09.004|issn=0976-5662|pmc=3880430|pmid=26403547}}</ref> In recent years, various digital shape capture systems have been developed which can be input directly to a computer allowing for a more sophisticated design. In general, the shape capturing process begins with the digital acquisition of three-dimensional (3D) geometric data from the amputee's residual limb. Data are acquired with either a probe, laser scanner, structured light scanner, or a photographic-based 3D scanning system.<ref>{{Cite journal|last1=Herbert|first1=Nicholas|last2=Simpson|first2=David|last3=Spence|first3=William D.|last4=Ion|first4=William|date=March 2005|title=A preliminary investigation into the development of 3-D printing of prosthetic sockets|url=https://pubmed.ncbi.nlm.nih.gov/15944878/|journal=Journal of Rehabilitation Research and Development|volume=42|issue=2|pages=141–146|doi=10.1682/jrrd.2004.08.0134|doi-broken-date=1 November 2024 |issn=1938-1352|pmid=15944878|s2cid=9385882 }}</ref>

After shape capture, the second phase of the socket production is called rectification, which is the process of modifying the model of the residual limb by adding volume to bony prominence and potential pressure points and remove volume from load bearing area. This can be done manually by adding or removing plaster to the positive model, or virtually by manipulating the computerized model in the software.<ref>{{Cite journal|last1=Sewell|first1=P.|last2=Noroozi|first2=S.|last3=Vinney|first3=J.|last4=Andrews|first4=S.|date=August 2000|title=Developments in the trans-tibial prosthetic socket fitting process: a review of past and present research|url=https://pubmed.ncbi.nlm.nih.gov/11061196/|journal=Prosthetics and Orthotics International|volume=24|issue=2|pages=97–107|doi=10.1080/03093640008726532|issn=0309-3646|pmid=11061196|s2cid=20147798}}</ref> Lastly, the fabrication of the prosthetic socket begins once the model has been rectified and finalized. The prosthetists would wrap the positive model with a semi-molten plastic sheet or carbon fiber coated with epoxy resin to construct the prosthetic socket.<ref name=":6" /> For the computerized model, it can be 3D printed using a various of material with different flexibility and mechanical strength.<ref>{{Cite journal|last1=Ribeiro|first1=Danielle|last2=Cimino|first2=Stephanie R.|last3=Mayo|first3=Amanda L.|last4=Ratto|first4=Matt|last5=Hitzig|first5=Sander L.|date=2019-08-16|title=3D printing and amputation: a scoping review|url=https://pubmed.ncbi.nlm.nih.gov/31418306/#:~:text=A%20scoping%20review%20was%20conducted,in%20the%20field%20of%20amputation.&text=Conclusions:%20The%20use%20of%203D,lower%20and%20upper%20limb%20loss.|journal=Disability & Rehabilitation: Assistive Technology|volume=16|issue=2|pages=221–240|doi=10.1080/17483107.2019.1646825|issn=1748-3115|pmid=31418306|s2cid=201018681}}</ref>

Optimal socket fit between the residual limb and socket is critical to the function and usage of the entire prosthesis. If the fit between the residual limb and socket attachment is too loose, this will reduce the area of contact between the residual limb and socket or liner, and increase pockets between residual limb skin and socket or liner. Pressure then is higher, which can be painful. Air pockets can allow sweat to accumulate that can soften the skin. Ultimately, this is a frequent cause for itchy skin rashes. Over time, this can lead to breakdown of the skin.<ref name="four">{{cite web|url=http://www.abc.net.au/science/slab/leg/default.htm |title=Getting an artificial leg up&nbsp;– Cathy Johnson |publisher=Australian Broadcasting Corporation |access-date=2010-10-03 }}</ref> On the other hand, a very tight fit may excessively increase the interface pressures that may also lead to skin breakdown after prolonged use.<ref>{{Cite journal|last1=Mak|first1=A. F.|last2=Zhang|first2=M.|last3=Boone|first3=D. A.|date=March 2001|title=State-of-the-art research in lower-limb prosthetic biomechanics-socket interface: a review|url=https://pubmed.ncbi.nlm.nih.gov/11392649/|journal=Journal of Rehabilitation Research and Development|volume=38|issue=2|pages=161–174|issn=0748-7711|pmid=11392649}}</ref>

Artificial limbs are typically manufactured using the following steps:<ref name="three" />
# Measurement of the residual limb
# Measurement of the body to determine the size required for the artificial limb
# Fitting of a silicone liner
# Creation of a model of the liner worn over the residual limb
# Formation of [[thermoplastic]] sheet around the model&nbsp;– This is then used to test the fit of the prosthetic
# Formation of permanent socket
# Formation of plastic parts of the artificial limb&nbsp;– Different methods are used, including [[vacuum forming]] and [[injection molding]]
# Creation of metal parts of the artificial limb using [[die casting]]
# Assembly of entire limb