TRANS - FEMORAL CASTING

ORTHOMANUAL

The Standard Quadrilateral Socket ( Hand Casting )

Written by: Markus Thonius OMM / CPO

based on pictures and experience

ICRC - Loki Orthopaedic Workshop 1994 / written 2001
This manual may be freely reviewed, abstracted, reproduced or translated, in part or in whole
but not for sale or for use in conjunction with commercial purposes
 TABLE OF CONTENTS

1 Introduction 2
2 Socket & Prosthetic Standard Design 3
3 Standard Quadrilateral Socket Design 4
4 Different Socket Parts 5
5 Cast Preparation 6
6 Casting of the Trans-Femoral Stump 7
7 Modification of the Negative Model ( Check Socket ) 13
8 Preparation of the Positive Model 22
9 References 28

1
 1. Introduction
This guide is written to repeat the standard procedures for hand casting of the quadrilateral
soc ket.Ia ma wa rethatmor emode rnshape sunde rt
hena me sof“ Na rr
owML”or
“CAT/ CAM”a remor ef unc ti
ona lforthepa t
ient. Nevertheless it is to mention, that they also
tolerate less mistakes of the technician.

The quadrilateral socket can also be produced with good brims for the stump entry part,
which facilitates work in mass production. But if the stumps are very short or have strong
contracture, it is good to know how to do a socket without industrial prefabricated brims.

2
2. Socket & Prosthetic Standard Design

3
 3. Standard Quadrilateral Socket Design

lateral 2-8 cm
frontal 2-4 cm
medial 1,5 cm

The level of the lateral and frontal wall depends on the stump length
 shorter stumps require higher walls for better pressure distribution and fixation

4
 4. Different Socket Parts

Proximal
Stump Entry Part
(weight bearing)

Volume Part

Distal Socket Part

The proximal Stump Entry Part can be replaced by a brim for mass production

5
 5. Cast Preparation

 Patient Data Paper

 3-4 POP- Bandages 15 cm
 Measurement tape
 Pencil
 Plaster- scissor
 Stockinet for the residual limb and pelvis
 Stockinet for the stump ( if possible TUBIGRIP)
 Vaseline
 Water pot

6
6. Casting of the Trans-Femoral Stump

7
 Cover the stump with vaseline

 Place one stockinet over the residual

limb/pelvis and one over the stump
( if possible elastic, TUBIGRIP )

 Marks on trochanter and along the

femur

8
 Marks along the femur for horizontal
measurements all 5-7 cm

 Take the circular measurements:

most important:
1. Proximal circumference
2. Centre muscle circumference
3. Distal circumference before the stump
end

9
 Cover the stump with 4 layers of POP
Bandage

 Use the classic cast grip for

quadrilateral socket design:

1. One hand horizontal under the tuber

2. One hand along the frontal scarpa
triangle
3. Both hands build an angle towards the
medial side
4. The stump is in normal adduction and
flexion
5. Check shape changes under muscle
contraction

10
 Lateral view

 Frontal view

11
 Cut the rope and stockinet

 Remove the negative model from the

patient

12
7. Modification of the Negative Model ( Check Socket )

13
 Prepare the proximal trim line of the
negative model

14
 Reduce the volume of the negative
model along the medial, proximal
stump entry part about 2-3 cm

 Reinforce the plaster model around

the proximal brim from outside to get
stronger

15
 The modified check socket

16
 Back view

 Medial view

17
 Reinforce the socket from outside with a POP- bandage for the check on the patient

18
 Check the socket on the patient and
correct the volume if necessary

19
 Perfect volume means that the patient can fix the socket with his muscle contraction

20
 Apply lateral and frontal a plumb line
on the check socket in normal
position

21
8. Preparation of the Positive Model

22
 Isolate the check socket with vaseline

 Place the check socket in a neutral

and functional position in a sand box

 Extend the model with a POP-

bandage

23
  Place a iron pipe in neutral functional
position in the model

 Remove the check socket

24
 Remove the vaseline with hot water

 Extend the stump length about 1-2 cm

25
The Finished Model:

 Back View

 Frontal View

26
 Lateral View

 Medial View

27
 9: References

 BOTTA / BAUMGARTNER:
Amputation und Prothesenversorgung der unteren Extremität
Enke Verlag

 BUNDESFACHSCHULE für Orthopädie-Technik Dortmund/Germany:

1. Praktische Modul-Ausbildungskurse
2. Prothetik für Auszubildende ( BIV-Verlag 1991)

 KAPANDJI:
Funktionelle Anatomie - Untere Extremität

28