Behind the scenes of a prosthetic fitting

A lot goes into getting a set of legs made.

Most of you will never know what it is like to have to go through this process,  but some of you have been through it multiple times! I am now working on perhaps my 7th set of prosthetic sockets in only three short years,  and I feel for my friends at Kentucky Prosthetics every time I have to come in.

As a bilateral amputee I have to go through the process twice,  once for each leg.  The average amputee is a single below knee amputee, but I am what I jokingly refer to as a “two for one special. ” Everything done for me has to be done twice.

When it comes to prosthetics the interface is the most important thing. You can have the latest and coolest electronic leg out there,  but if you don’t have a good fitting socket all you really have is a high priced paperweight.

On my most recent visit to Kentucky Prosthetics I asked Matt if I could follow him around in the shop and get a few pictures and video of the process, so the average person can see what kind of patience and craftsmanship must go into making a great set of sockets. Of course he said yes….  He learned a long time ago I don’t accept no for an answer!

Casting the limb is the very first part of the process,  and arguably the most important.  If the cast does not capture the perfect picture of the limb,  than the socket ill not fit properly.  Every different type of socket has it’s own casting technique as well.  Here I have been cast and then put under vacuum to get a proper “picture” of my leg.

Vacuum assisted casting
Vacuum assisted casting
ready for cast material

Once the castings have been completed they will be set up and prepared for pouring of a plaster material that will eventually become the basis of my limb castings. (shown above)


Each casting has to be poured and then set with a piece of hardware that will allow the casts to be set in a vice and and sculpted when they are set and dry.

So far all of this seems pretty old school, right? Why not take some high tech scanner and scan my leg into a computer and have a C&C machine make the cast? Well, Kentucky Prosthetics has the equipment to do that, but you must remember that every limb and every socket is different! If I had been cast with the 3D scanner, I would never properly fit into the sockets being made for me. High tech is great, but sometimes old-school is the only way to go to get a perfect fit!

Here is what the casting look likes when set:

Once the cast has been set and shaved a bit, it then goes through the process of being “pulled” into a plastic check socket:

After the socket has been pulled, my prosthetist goes through the lengthy process of pulling, trimming, and forming the plastic socket to a perfect fit.

Once all of this has been completed, he has to turn around and do the entire thing over again for my other leg! And this is almost the easy part… Once the sockets are done they have to be properly aligned, fixed, and then put on my Harmony P3 system and feet so the whole thing can be aligned to my walking.

This entire process started on a Thursday afternoon and finished early on a Saturday afternoon. That’s nearly two working days to get my fit just the way I want it. Perfection takes time, and old-school craftsmanship isn’t done in a few hours.

I am now waking around in the test sockets, just to see how they feel. Once we agree that the fit is what I want, those test sockets will be turned into a permanent set of very cool sockets that I shouldn’t have to change for a long time!

Thanks to my friends at Kentucky Prosthetics for all the hard work you put into keeping me walking!