If you’ve ever worn an upper limb prosthesis, you understand that a comfortable, well-fitting socket is essential. When the socket doesn’t feel right, when it irritates or hurts your residual hand or arm, it’s easy to predict what will happen next: You’ll stop wearing it.
It’s like walking around in a pair of great looking, expensive shoes that are so uncomfortable you can’t wait to get them off your feet. After a couple of outings, and maybe a blister or sore toe, those shoes end up in the back of the closet.
Of course, it’s a much bigger deal with a prosthesis, where the whole point is to make it easier for you to get things done. That’s why Arm Dynamics prosthetists are focused on creating customized upper limb devices that help people thrive.
Our sockets are designed to conform perfectly around the unique shape of each person’s residual limb. While sockets are usually made from thermoplastics, a more advanced material — silicone — provides an intimate, cushioning socket that helps increase wear-time and improve control of a prosthesis.
Thermoplastic is still a good material for test sockets, diagnostic fittings and people who require more rigidity around their residual limb. But for advancing the comfort and use of a prosthesis, custom silicone sockets are superior.
Advantages of Silicone
Silicone sockets are significantly more comfortable than thermoplastic sockets due to the soft and supple texture of the material. It naturally accommodates the complex limb shapes of people with upper limb loss or limb difference.
Mandie Tavares is a congenital amputee who had a thermoplastic test socket before receiving her rolled silicone socket. That’s her in the photo below, making pizza with her daughter, Scottie.
“There was a big difference in how the two sockets felt,” she said. “The rolled silicone is much more comfortable and flexible. It helps me be able to wear my prosthesis longer. On the days that I’m out and about, I wear it all day long.”
Silicone mimics the properties of human skin. To get an idea of what it feels like, press on the bare skin of your arm or leg. Notice how it’s cushiony and moves easily and naturally beneath your touch. In much the same way, your shortened upper limb moves smoothly against the flexible inner layer of a silicone socket. There’s no friction or discomfort.
Fire Chief Joe Yeakley of Lindale, Texas, pictured below at the fire station, said that silicone is easy on his scars. "It's worked out really well for me. When I'm teaching new firefighters, I'll wear the prosthetic for eight hours or more," he said. "I don't have a lot of fatty tissue on my hands and the silicone provides some additional cushioning and comfort in those bony areas."
Because silicone is hypoallergenic and biocompatible, it’s especially beneficial for people with burns, scars or sensitivity to synthetic materials like plastic. It even has healing properties that, over time, promote the growth of new skin.
Silicone sockets feel lighter and cooler, and patients sweat less inside the socket. They’re easy to clean and more durable for the long run than plastic sockets.
Bilateral, below-elbow amputee Jason Koger was surprised at the big differences between thermoplastic and silicone sockets.
“Even though my first arms made by my prosthetist were comfortable, once I got into the rolled silicone, it was almost a game changer,” he said. “The main reason was because of the weight. Even though it’s not actually lighter, it feels 10 pounds lighter, and it’s much cooler too.”
Silicone sockets like the ones pictured above can be tinted to just about any color. Being able to choose a custom color lets you make your prosthesis more unique, which adds a little fun factor — especially for kids who wear a prosthesis.
Fitting and Fabricating Silicone Sockets
Silicone is made from a naturally occurring chemical element called silicon. Most of our sockets incorporate two types of silicone: a soft, cushioning inner layer that’s in direct contact with the residual limb, and a firmer outer layer of rolled silicone for the socket’s exterior.
Silicone sockets can be made for any level of upper limb loss, from partial finger to shoulder. Making a socket involves multiple steps and takes a specially trained silicone technician several days of careful work.
Fitting begins with the prosthetist casting the person’s residual limb and using the cast to create a plaster model of the arm or hand.
The inner layer of silicone is injected around the plaster model of the residual limb. Additional layers are applied to the areas that need extra cushioning, like bony prominences or scars.
While the softer silicone is drying, the firmer silicone is milled with an automated silicone roller. When it becomes soft and pliable, pigment is added to create any color the patient chooses.
The rolled silicone is carefully applied by hand on top of the injected silicone and trimmed to create the durable, outside structure of the socket.
The two-layer socket is placed in a curing oven for about 16 hours to bond the two silicones. After it has cooled, the socket is removed from the model, trimmed and polished, and is ready for the patient to try on.
Custom silicone sockets offer enhanced comfort and function for people who rely on an upper limb prosthesis.
If you've experienced the benefits of a silicone socket, please share your story in the comments below. If you'd like to meet with an Arm Dynamics prosthetist to discuss silicone, please complete the form at the bottom of the page and someone will contact you.
The video below explains more about the advantages of silicone and lets you meet people who are living active lives with custom silicone sockets.
For more information, see related articles and resources here:
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