Analysis of Pressure Distribution in Transfemoral Prosthetic Socket for Prefabrication Evaluation via the Finite Element Method.

In this study, we estimated and validated the pressure distribution profile between the residuum and two types of prosthetic sockets for transfemoral amputees by utilizing a finite element analysis. Correct shaping of the socket for an appropriate load distribution is a critical process in the design of lower-limb prosthesis sockets. The pressure distribution profile provides an understanding of the relationship between the socket design and the level of subject comfortability. Estimating the pressure profile is important, as it helps improve the prosthesis through an evaluation of the socket design before it undergoes the fabrication process. This study focused on utilizing a magnetic resonance imaging (MRI)-based three-dimensional (3D) model inside a predetermined finite element simulation. The simulation was predetermined by mimicking the actual socket-fitting environment. The results showed that the potential MRI-based 3D model simulation could be used as an estimation tool for a pressure distribution profile due to the high correlation coefficient value (R2 > 0.8) calculated when the pressure profiles were compared to the experiment data. The simulation also showed that the pressure distribution in the proximal area was higher (~30%) than in the distal area of the prosthetic socket for every subject. The results of this study will be of tremendous interest for fabricators through the use of a finite element model as an alternative method for the prefabrication and evaluation of prosthetic sockets. In future prosthetic socket fabrications, less intervention will be required in the development of a socket, and the participation of the subject in the socket-fitting session will not be necessary. The results suggest that this study will contribute to expanding the development of an overall prefabrication evaluation system to allow healthcare providers and engineers to simulate the fit and comfort of transfemoral prosthetics.

Management of Inguinal Vascular Graft Infection by Lateral Femoris Axillo-Popliteal Bypass / 日本心臓血管外科学会雑誌

A 81-year-old man was referred to our hospital for treatment of a skin ulcer of the right anterior crus. After 2 months left common femoral artery-right popliteal artery bypass, graft infection was occurred and methicillin-sensitive <i>Staphylococcus aureus</i> was found in the bacterial culture. The wound was extended in order to decide the extent of graft infection, but graft healing was totally insufficient. All of the graft was excised, and right axillo-popliteal bypass using 8mm Bionit graft was performed. The graft was passed through lateral femoral. Thus, in this case the graft excision was necessary, but major amputation could be avoided by successful revascularization.