Silicone soft socket system: its effect on the rehabilitation of geriatric patients with transfemoral amputations.

OBJECTIVE: To report the effect of supplying new transfemoral amputee patients with a prosthesis with a silicone suspension/interface system. PATIENTS AND DESIGN: Fifty-eight new transfemoral amputee patients were supplied with a contoured adducted trochanteric-controlled alignment method (CAT-CAM) socket (CCS) with a silicone suspension/interface system. This system is called the Icelandic roll-on silicone socket, or the ICEROSS system (IRS). A second group of 18 new amputee patients were supplied with an unlined CCS (uCCS), ie, without silicone sleeve suspension. MEASURES: The IRS group was followed up at 1 year, the uCCS group at 9 months. Ambulatory capacity was investigated by first categorizing patients' prosthetic mobility into four different groups based on the distances patients were able to ambulate: 0 m (wheelchair ambulation only), <100 m, 100 to 500 m, and >500 m. The change in distance ambulated was then determined for each group for the three time intervals between admission, discharge, and follow-up. RESULTS: Between discharge and follow-up patients with the IRS had a significantly greater improvement (p<.001) in distance traversed than patients supplied with the uCCS. Distance traversed had been longer in the uCCS group before they were supplied with the prostheses (p<.05). Inpatient stay in the rehabilitation center was 5 days less in the group supplied with IRS (p<.05). Adjustments to the new socket had to be carried out for 67% of the uCCS group during the observation period, compared with only 21% for those using the IRS system. Satisfaction, average duration of daily use, and the use of assistive devices for gait did not differ significantly. CONCLUSIONS: New patients with transfemoral amputations fitted with a silicone suction socket showed greater gains in distances ambulated, and adjustments to their prostheses were significantly fewer. Therefore, it is preferable to provide these sockets to geriatric amputee patients rather than CAT-CAM sockets without silicone suspension sleeves.