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CHAPTER 30
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The Child with a Limb Deficiency
Similarly, the weight-sensitive areas most affected include the
tibial crest, fibular head, distal tibia and fibula, peroneal nerve,
and the patella. The socket design is composed of an outer shell,
inner soft liner, and a cosmetic cover.
The patellar-tendon-bearing (PTB) socket is the stan-
dard socket (Fig. 30-48A). It provides the least suspension,
and for that reason, is not often suitable for young children.
The supracondylar/suprapatellar (SCSP) transtibial socket
design (Fig. 30-48B) allows for suspension without the need
for belts or cuffs. The medial, lateral, and anterior walls extend
proximally, to fully enclose the patella and femoral condyles.
The SC transtibial socket (Fig. 30-48C) is almost identical to
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C
D
E
FIGURE 30-48.
Common sockets and suspensions for transtibial pediatric amputees.
A
: PTB socket is most useful for the
mature patient. It gives the most freedom of motion, but the least secure suspension.
B
: The PTB-SCSP design gives the
most secure suspension and best knee control of any of the sockets that incorporate the suspension in the socket.
C
: The
PTB-SC socket eliminates the suprapatellar portion of the socket anteriorly, providing better range of motion but less control of
hyperextension.
D
: The SC cuff suspension is a common suspension used in the pediatric age range.
E
: The neoprene sleeve
suspension provides very secure suspension for the very active amputee. This can also be used for the transfemoral amputee.
A
Quadriceps bar
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B
