Advancement in Socket Technology for

Transradial Prosthesis
Presented by
Sagar Prasad Das
MPO 2nd year, 7th Batch
Introduction
• According to statistics, 77% of upper limb amputations are caused by
traumas, 8.9% by congenital deformity, 8.2% by tumors, 5.8% by diseases,
and 0.1% due to uncommon reasons.Transradial amputation is the most
common major upper limb amputation and has the highest prosthetic
acceptance rates of amputations performed in the upper limb .
• The ultimate goal of a prosthetist is to provide a device that will not only be
functional by clinical standards but will also provide good function for the
patient
SOCKET
• One of the single most determining factors of
whether a person will use a prosthesis is prosthetic
socket design.
• The traditional socket designs were mainly focused
on maintaining the stability of the prostheses and
tissue containment of the residual limb.

⦿ socket designs and careful consideration of residual

limb presentation sets
the stage for patient success-
1. maximizing range of motion.
2. providing stability throughout daily activities.
3. comfortably distributing the forces exerted on the
residual limb during movement and suspension.

⦿ Socket design for body powered prosthesis-

4. Harness suspended
 NORTHWESTERN SUPRACONDYLER
SOCKET
• The Northwestern University (NWU) Supracondylar Suspension
Technique designed by Billock in 1972.
• Accommodate all lengths of transradial amputations.
• Provide an improved range of motion at the elbow.
• Narrow M-L
• Anterior trimline is below antecubital area,
• The anterior trimline, superior to the humeral condyles, should
be at least 3/8 inch smaller than the measured M-L dimension at
the humeral condyles.
• Posterior trimlines be well rounded
to accept the contour of the upper
arm, proximal to the humeral
condyles 1/2inch over the olecrenon
process.
MODIFIED SUPRACONDYLER BRIM
• Mainly for myoelectric Transradial prosthesis.
• Has a olecrenon cut-out.
• Also called three-quarter type below-elbow socket.
• Cut-out length should not exceed 50% of the axial stump length.
 TRANSRADIAL ANATOMICALLY CONTOURED
(TRAC SOCKET)
• In 2003, Miguelez et al. Described this socket.
• Incorporates design elements from both the muenster and northwestern
•interfaces with more aggressive contouring of the anatomy to maximize load
tolerant areas of the residual limb.
• Compression anterior and slightly inferior to the epicondyles, specifically
about the radial head on the lateral aspect.
• On anterior/posterior plane, suspension is achieved by compression into the
cubital fold and supra-olecranon region.
• The TRAC retains the high olecranon encapsulating posterior
trim line
• The anterior trim line extending to the cubital fold with a
channel that allows relief for the biceps tendon.

• Relies on hydrostatic pressure.

The position and degree of displacement of the skeletal
substructure while wearing the TRAC interface are less affected
during loading.

• The TRAC addresses the deficits of previous designs by

contouring five key areas:
1) the antecubital region,
2) the olecranon region,
3) the epicondylar region,
4) the distal radial region, and
5) the wrist extensor and flexor musculature

TRIMLINE:
⦿ Anterior:- follows the cubital fold.
⦿ Medial and lateral:-should parallel the medial border of the
ulna and the
• lateral border of the radius.
⦿ Posterior:-approximately 12 to 18 mm proximal to the
superior aspect of the olecranon, with a width similar to the
width of the olecranon
High-performance variable suspension
prosthesis (HPVSP)
• After experiences with each of these
systems, Radocy designed the high-
performance variable suspension
prosthesis (HPVSP) in 1995 .

• which is a transradial supracondylar

socket (modified Muenster) that is
combined with 3S or Icelandic Roll-
On Silicone Socket (ICEROSS)
suspension technologies.
• The variable suspension prosthesis
(VSP) is a viable alternative for
short- to mid-length transradial
amputees who demand rigorous
sporting activities and need
increased prosthesis’ versatility
 WILMER OPENSOCKET
• The WILMER open socket is a tubular open socket design
introduced by Plettenburg in 1998 designed by Delft
University of Technology in the Netherlands.
• This socket design, made of soft-covered stainless steel tubes,
supports the arm only at the minimal fitting areas that are
required for good fixation of the socket.
• Meanwhile, the socket is strong enough to transmit force and
motion between the residual limb and prosthesis.
• The socket can be easily put on and off and is continuously
adjustable during the day. Unlike fullcontact sockets, the steel
tubes cause the resulting construction to be open, providing
good ventilation of the skin.
• In conclusion, the main advantages of the WILMER open
socket are the open structure, the contact of the elbow with its
surroundings, and the easy donning and doffing.
• The main problem of the WILMER open socket is the
unaesthetic look and the difficult manufacturing technique. The
WILMER open socket has been accepted as a standard
prosthetic socket in several rehabilitation centers in the
Netherlands.
COMPRESSION–RELEASE
STABILIZATION (CRS) SOCKET
• The high-fidelity interface, or compression-
stabilized interface proposed by Randall Alley in
2011, is based on compression–release
stabilization (CRS) theory, which focuses
primarily on control of the underlying bone along
their entire length through alternating soft tissue
compression and release.
• Reduce motion of the underlying bony
structures with respect to both the socket and the
rest of the prosthesis.
• The depressions and releases during cast-taking
but only by radically changing the way casts are
taken.
• Requires selective pressure during cast-taking.
 Anatomically contoured and controlled
interface (ACCI)
• ACCI was used for short transradial amputation
by Alley in 2002. The ACCI introduced by the
author in the early 1990s controls axial rotation by
extending the medial and lateral stabilizers more
proximally than in earlier designs and adding
supracubital fossae anterior and proximal to the
humeral epicondyles, avoiding the often reported
discomfort in earlier designs that suspended
directly proximal to the epicondyles.
• The ACCI adds radial channels to the distal
volume, which offers additional rotational
stability, as well as an extended brim up to the
cubital fold, and the radial channels also ensure
sufficient soft tissue contact along the length of
the entire limb throughout all ranges of motion
reducing distal end discomfort.
Recurrent convolutional neural network
(RCNN)
• A myoelectric prosthesis connects to a user’s residual limb via a socket and is
normally controlled using electromyography (EMG) signals. EMG signals are
generated by residual muscle contractions, detected by surface electrodes within
the socket, and transmitted to the device’s onboard controller.
• Pattern recognition-based controllers decode these signals to predict the user’s
intended movements and send corresponding commands to the device’s motors.
• The most advanced controllers generally use a classification algorithm (model),
which predicts one device action (or class) at a time.
• RCNNs are a type of network architecture for deep learning, capable of learning
directly from and handling large amounts of multimodal data These capabilities
lend themselves to the capture of limb position data for improved device control.
• In our prior work, we merged EMG data with accelerometer data from an inertial
measurement unit (EMG+IMU) using an RCNN . We also tested an EMG+IMU
regression-based control model (RCNN-Reg) and found that regression models can
yield smooth device movements, given that they can predict multiple movements at
once, each proportional to muscle contraction intensity and across multiple limb
positions
• In their case study contributes, for the first time, evidence that an RCNN
regression-based controller offers a user with transradial amputation control of
their prosthetic wrist and hand simultaneously across multiple limb positions,
using varied velocities.
• RCNN-Reg successfully mitigated the limb position effect during device use,
given that our participant was able to retain control of their myoelectric
prosthesis throughout numerous re-orientations of their limb in space during
different tasks.
• Although regression-based control solutions have not garnered as much
research attention as classificationbased counterparts, the merits of RCNN-
Reg, as presented in this paper, suggest that it be strongly considered as a
future prosthesis controller.

• (Reference: EVIDENCE THAT A DEEP LEARNING REGRESSION-BASED CONTROLLER MITIGATES THE LIMB
POSITION EFFECT FOR AN INDIVIDUAL WITH TRANSRADIAL AMPUTATION Heather E. Williams1,2, Jacqueline S.
Hebert1,3, Patrick M. Pilarski*2,3, Ahmed W. Shehata*1,3 1Dept. of Biomedical Engineering, University of Alberta, Edmonton,
Canada; 2Alberta Machine Intelligence Institute (Amii), Edmonton, Canada; 3Dept. of Medicine, University of Alberta * These
authors contributed equally to this work.)
3D PRINTED SOCKET
 REFERENCES
• The Munster-Type Below-Elbow Socket, an Evaluation, Artificial Limbs, Vol. 8,
No. 2, pp. 4-.14, Autumn 1964.
• The Northwestern University Supracondylar Suspension Technique for Below-
Elbow Amputations,
• Prosthetic sockets stabilized by alternating areas of tissue compression and
release , JRRD Volume 48, Number 6, 2011 Pages -679–696 .
• Atlas of prosthetics, 4th edition
• Advances in Sockets, inMotion Volume 13, Issue 5 September/October 2003
• Affordable and Faster Transradial Prosthetic Socket Production Using
Photogrammetry and 3D Printing Rifky Ismail 1,2,*, Rilo Berdin Taqriban 1 ,
Mochammad Ariyanto 1,2 , Ali Tri Atmaja 1 , Sugiyanto 1 , Wahyu Caesarendra
3,* , Adam Glowacz 4 , Muhammad Irfan 5 and Witold Glowacz , September 2020
• EVIDENCE THAT A DEEP LEARNING REGRESSION-BASED
CONTROLLER MITIGATES THE LIMB POSITION EFFECT FOR AN
INDIVIDUAL WITH TRANSRADIAL AMPUTATION Heather E. Williams1,2,
Jacqueline S. Hebert1,3, Patrick M. Pilarski*2,3, Ahmed W. Shehata
• A Multiuser Transradial functional Test socket for validation of new Myoelectic
prosthetic control stratgies Taylor C. Hansen1 *, Abigail R. Citterman1,2, Eric S.
Stone1 , Troy N. Tully 1 , Christopher M. Baschuk 2 , Christopher C. Duncan3 and
Jacob A. George1,3,4 *2022
THANK YOU