decrease in the volume of the residual limb results in a socket that is either too tight or too loose, respectively.
Numerous factors contribute to prosthesis fit, including socket design, normal daily volume fluctuations, and
long-term changes in limb volume. Poor socket fit remains the primary concern of lower limb amputees with regard to
their prostheses.1
Volume fluctuations occur, in part, because of physiological volume changes of the residual limb resulting from
normal ambulation and especially from the high compressive pressures exerted upon the limb. Volumetric changes
occur hourly, daily, and monthly.
There are limited data in the literature that quantify volume fluctuation that occurs in the residuum over the course
of the day. Residual limb volume changes of between -11% and +7% support the argument that the socket fit
changes throughout the day.2 A volume increase of +3% to 5% may cause significant difficulty for an amputee
donning his/her prosthesis.3 The amount of daily volume fluctuation varies greatly among individual amputees and is
a function of prosthesis fit, activity level, ambient conditions, body composition, dietary habits, and for women,
monthly cycles. Current methods used to compensate for daily volume changes in the limb include multiple socks,
pads, varying suspension liner thicknesses.
1. Legro MW, Reiber G, del Aguila M, Ajax MJ, Boone DA, Larsen JA, Smith DG, Sangeorzan B. Issues of importance
reported by persons with lower limb amputations and prostheses. J Rehabil Res Dev. 1999;36:155-163.
2. Board WJ, Street GM, Caspers C. A comparison of trans-tibial amputee suction and vacuum socket conditions.
Prosthet Orthot Int. 2001;25:202-209.
3. Fernie GR, Holliday PJ. Volume fluctuations in the residual limbs of lower limb amputees. Arch Phys Med Rehabil.
1982;63:162-165.
| Amputee Limb Volume Management (click on a category) |
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| Every amputee is aware of the fact that their residual limb changes shape over time. Most amputees experience some level of volume change during the course of day that can range from subtle to drastic. Factors that affect the volume of the limb include reduction of postoperative edema, muscle atrophy, changes in body weight and the temporary reduction of fluids in the limb caused by the normal pumping action of walking in a prosthesis. |