Abstract
Chapter I introduces in brief the current problems of Below-Knee socket fitting, and aims of the author in overcoming these by developing a new casting technique. Chapter II gives a brief account of the historical developments of lower extremity amputations and prostheses. The modem concepts of amputations and prostheses is presented. Chapter III deals with the various anatomical and physiological factors to be taken into account in designing a successful below knee socket. Chapter IV deals with the surgical considerations in the management of a below knee amputee. The commonly used surgical techniques for performing a below knee amputation are discussed. The critical assessment of the advantages and disadvantages of each surgical technique in terms of socket fit are described. In Chapter V, the biomechanical principles to provide comfort, stability and functional connection between the stump and the socket of a patellar-tendon-bearing prosthesis are dealt with. In Chapter VI, a critical review of the existing casting techniques for the production of a Patellar-Tendon-Bearing socket is presented. Chapter VII introduces the authors concept of obtaining a total contact cast by the use of air pressure of controlled magnitude and uniform distribution, as an alternative to hand wrap casting technique. A method to implement the concept in clinical situation is proposed to achieve uniform pressure distribution at the time of casting and incorporation of other biomechanical features in the cast itself. Chapter VIII discusses in detail the method of producing the stump casts by the air pressure casting technique for making below knee sockets. In Chapter IX, criteria for selection of patients for the clinical trials and indications in routine practice for the new socket are discussed. Chapter X describes the organisation of the clinical trials and the results obtained. In Chapter XI, the work done is reviewed to determine how far it has achieved its objectives. The further work still to be undertaken, and the other applicabilities of the concept of air pressure casting are suggested.