Development of Refined Fitting Procedures for Lower-extremity Prosthese

With the development of the patellar-tendon-bearing prosthesis by the University of California at Berkeley, many new advantages in simplicity, comfort, and function were available to the below-knee amputee. However, there still exists the problem of concentrated pressures over small areas of the stump. The original design of the patellar-tendonbearing prosthesis was intended to distribute the load over areas of the stump which were considered to be pressure-tolerant areas. These areas are quite small in relation to the overall stump surface. The concentration of pressure on the patellar tendon, the medial flare of the tibia, the distal end of the stump, and the popliteal area has in many instances resulted in stump breakdown and patient discomfort. Refinements in the technique of the patellar-tendon-bearing prosthesis in many parts of the country have eliminated many of the problems of concentrated pressure in small areas. The concept of suspending the below-knee stump in a socket by tightly fitting the anterior-posterior dimension of the stump into the socket has fallen into disfavor in most