Hi-Fidelity Socket Interface

Matthew Garibaldi, C.P.O.

University of California, San Francisco

Agenda
Historical concerns with longbone prosthetic fittings

Hi-Fidelity concept
Radial level issues Hi-Fi radial app.

Humeral level issues

Hi-Fi humeral app. Femoral level issues Hi-Fi femoral app. Current studies

Historical Concerns
Long-bone stabilization within soft tissue Comfort Heat

Historical Concerns
Long-bone stabilization within soft tissue Comfort Heat

Historical Concerns
Long-bone stabilization within soft tissue Comfort Heat

Hi-Fidelity Concept
By utilizing a four-strut compression system which effectively loads the soft tissue surrounding the residual bony segment, and with the incorporation of associated tissue relief, one can achieve maximal long bone stabilization outside of the confines of basic hydrostatic limitations.

Radial Level Issues

Unwanted motion within socket Distal anterior radial pressures

ROM limitations

Radial Level Issues

Unwanted motion within socket Distal anterior radial pressures

ROM limitations

Radial Level Issues

Unwanted motion within socket Distal anterior radial pressures

ROM limitations

Hi-Fi Radial App.

By compressing the soft tissue between the radial/ulnar long-bones and the associated flexor/extensor mm bellies, and allowing soft tissue to flow anteriorly, posteriorly, medially, and laterally without restriction, a greater depth of compression is achieved along the shaft of the residual bony segments.

Hi-Fi Radial App.

Increased socket control

Decreased distal radial pressures

Increased ROM

Increased comfort
Decreased heat

Hi-Fi Radial App.

Increased socket control

Decreased distal radial pressures

Increased ROM

Increased comfort
Decreased heat

Hi-Fi Radial App.

Increased socket control

Decreased distal radial pressures

Increased ROM

Increased comfort
Decreased heat

Hi-Fi Radial App.

Increased socket control

Decreased distal radial pressures

Increased ROM

Increased comfort
Decreased heat

Hi-Fi Radial App.

Increased socket control

Decreased distal radial pressures

Increased ROM

Increased comfort
Decreased heat

Underlying Structures

Humeral Level Issues

Unwanted motion within socket Distal lateral humeral pressures

ROM limitations
Medial brim vascular compromise

Poor suspension

Hi-Fi Humeral App.

By compressing the soft tissue between the humeral long bone and the associated biceps/triceps mm bellies, and allowing soft tissue to flow anteriorly, posteriorly, medially, and laterally without restriction, a greater depth of compression is achieved along the shaft of the residual bony segment.

Hi-Fi Humeral App.

Increased socket control

Decreased distal humeral pressures

Increased suspension

Increased comfort
Decreased heat

Hi-Fi Humeral App.

Increased socket control

Decreased distal humeral pressures

Increased suspension

Increased comfort
Decreased heat

Underlying Structures

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Femoral Level Issues

IT pressures

IC complications
PR/IR pressures (PAIN) Socket rotation ROM limitation Femoral abduction

- lateral trunk lean

- distal lateral pressure

Hi-Fi Femoral App.

Use conical shape to your advantage Focus on regions below zero level

Implement Hi-Fi design

Hi-Fi Femoral App.

Use conical shape to your advantage Focus on regions below zero level

Implement Hi-Fi design

Hi-Fi Femoral App.

Use conical shape to your advantage Focus on regions below zero level

Implement Hi-Fi design

Hi-Fi Femoral App.

Use conical shape to your advantage Focus on regions below zero level

Implement Hi-Fi concept

Hi-Fi Femoral App.

Elimination of IC

Lower medial wall

Rotational control Stabilization of femur in socket Increased ROM

Hi-Fi Femoral App.

Elimination of IC

Lower medial wall

Rotational control Stabilization of femur in socket Increased ROM

Hi-Fi Femoral App.

Elimination of IC

Lower medial wall

Rotational control Stabilization of femur in socket Increased ROM

Hi-Fi Femoral App.

Elimination of IC

Lower medial wall

Rotational control Stabilization of femur in socket Increased ROM

Hi-Fi Femoral App.

Elimination of IC

Lower medial wall

Rotational control Stabilization of femur in socket Increased ROM

Underlying Structures

General Protocol

Edge/Strut Pressures

Weightbearing Assessment

Tissue Flow

Gait Evaluation

Case Study
60 y/o female

Wheelchair bound 10 years

25 degree HFC

General deconditioning

Whats To Come
Jig System

Studies
Blood Perfusion Studies Doppler Readings

Studies
Skin Pressure Testing F-Socket Readings