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Vol. 27, Art. 45 (pp. 1109-1139)    |    2026       

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Сurrent methods for assessing the residual limb - socket interaction in transtibial prosthetic fitting

Nikolaenko A.N., Demchenko N.A., Ermishin V.M.
Federal State Budgetary Educational Institution of Higher Education “Samara State Medical University” of the Ministry of Healthcare of the Russian Federation, 89 Chapaevskaya St., Samara, 443099, Russian Federation

Brief summary

The interaction between the transtibial residual limb and prosthetic socket is a major determinant of tolerance of prosthesis use, soft-tissue condition, suspension stability, and functional performance. Socket fitting traditionally relies on clinical examination, patient feedback, and professional expertise, whereas residual-limb shape and volume changes and local load redistribution create a need for objective assessment. Objective. To systematize current clinical and instrumental methods used to assess the transtibial residual limb-socket interface and to determine their measured parameters, strengths, limitations, and potential role in combined assessment. Materials and methods. A literature review with a structured search was conducted using PubMed/MEDLINE, official platforms of Russian peer-reviewed journals, and the reference lists of key reviews. The main search period was 2019-2026; earlier landmark publications were included when methodologically relevant. Clinical and patient-reported assessment, residual-limb morphometry and volume monitoring, three-dimensional scanning, interface pressure, shear and relative motion assessment, thermal monitoring, and sensor technologies were analyzed. Owing to substantial methodological heterogeneity, thematic qualitative synthesis without meta-analysis was used. Results. No single method provides a comprehensive characterization of the prosthetic interface. Clinical examination is essential for tissue assessment but may not detect subclinical overload. Anthropometry, bioimpedance, and 3D scanning quantify residual-limb geometry and volume but do not directly determine tissue load tolerance. Interface-pressure measurement can identify local overload and quantify changes after socket modification; however, universal clinically meaningful pressure thresholds have not been established. Shear, pistoning, temperature, and humidity measurements provide additional information but remain predominantly research-oriented. Conclusion. A combined clinical-biomechanical approach integrating tissue condition, longitudinal morphometric assessment, patient-reported socket tolerance, and objective mechanical measurements appears most promising for individualized socket fitting.


Key words

transtibial amputation; residual limb; prosthetic socket; socket fit; interface pressure

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Журнал основан 16 ноября 2000г.
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