Digital modification of a residual limb - how to cover your bases for a great fitting socket
To find the “perfect fit” is key for practitioners to provide the best patient care possible. This is why digital tailoring will continuously play a bigger role in O&P as it enables clinicians to work more efficiently and achieve even higher degrees of accuracy. Nevertheless, a practitioner's experience to palpate the residual limb itself, mark bony structures, and use this to plan the treatment will always be the fundamentals of a great fitting socket.
The practitioner's experience is indispensable when it comes to bringing it all together: Starting with scanning and measuring the patient, followed by modifying the residual limb and manufacturing the socket. For all these steps digital tools offer possibilities to enable a prosthetist to apply their chosen methods to ensure the best fit.
Why bother about modifying a residual limb online?
What are the benefits of working digitally in prosthetics? How will working digitally result in better patient care? These are fair questions. Let's take a look at the most important benefits:
Comfortable for your patient & healthy on your back For patients, scanning is often perceived as being more comfortable and less intrusive compared to plaster casting. And don't forget about your own health: 3D scans are a lot easier on your back than handling heavy casts and molds. When working digitally there is no need to take a plaster cast, fill a mold, dry it and lug it around for further processing. When working digitally you simply scan your patient and upload the scan. Tip: For prosthetics it´s most beneficial to work with scanners that are able to transfer color information (.obj - files). Then you will be able to mark all important areas for the scan and use these as a reference later in the modifying process.
More accuracy & flexibility in working digitally compared to working with plaster Working digitally allows the practitioner to redo and undo modifications with a mouse click. Clean, fast and easy. Precise measurements can be taken at any given point on the residual limb within the software. Volume adjustments, for example, can be executed in millimeters or percentages. All modifications can be monitored continuously and single steps along the way can be saved to use again at a later point in time i.e. when the model needs to be adjusted because of weight fluctuations of the patient.
Excellent reproducibility, traceability of process steps & easy accessibility Using digital processes, a clinician is able to save valuable process steps with comments if needed along the way. That will ensure easy documentation of each patients’ case, making it retrievable at a later point in time, for example when making adjustments after fitting the check socket. There is no need for a physical storage room for plaster molds. You can easily pull up needed information via data storage for upcoming iterations of a socket design. Thanks to cloud-based access to software and storage you can pull up all needed information anytime, anywhere.
The digital toolbox for residual limb modeling on the Mecuris Solution Platform
In order to make our platform easier to use for prosthetic use cases, we have been working on developing and advancing the functionalities within the Mecuris3D Modeling tool. This development was closely substantiated by our customers´ feedback and requirements. Therefore, together with practitioners, we have identified the key functionalities that will help you the most in modeling residual limbs and set up a roadmap for future adjustments.
In the following paragraph we have compiled the functionalities within our software that are most crucial for the creation of a positive model on our platform. Read on to get an overview of the possibilities in the Mecuris Solution Platform. On the bottom of this blogpost we also provide you with a link to an on-demand Webinar that will walk you through it as well.
Posture correction of a knee joint
In case your TT (transtibial) scan is not in the preferred position you can adjust the knee joint in the Mecuris 3D Correction tool. By setting landmarks you can create a skeleton in the scan and this allows you to adjust the extension & flexion as well as the vagus & valgus of the knee joint.
Mecuris now allows you to upload .obj files into the Mecuris 3D Correction and Mecuris 3D Modeling tool. Thanks to this file format color information from a patient scan can be displayed. Feel free to mark certain areas (i.e. pressure points) before scanning to see them on the scan later on.
With the interval measurement tool you can add a plane and create measurements in defined intervals, i.e. at a set distance of 3cm. This allows you to determine exactly how much material (in percentages and millimeters) you want to add or remove in order to achieve the suitable circumference. During the modeling process you can always check your measurements in this section.
Change local circumferences
In the offset tool you can find a section where you can change circumferences of your model with a few clicks. After taking interval measurements you are able to adjust circumferences in percent, millimeters or with a section offset. This new feature allows you to reduce or increase sections of a residual limb by a defined value (i.e. 2 %).
3D file of the positive model
After finishing modifications you can download the 3D file in the Mecuris3D Modeling tool to continue with one of these options:
Send the file to your Central Fabrication Service for carving or 3D printing. If you have a FDM printer in your lab you can manufacture the positive model in house. You can use this positive model to continue with traditional ways of manufacturing a socket.
Send the file to a Central Fabrication Service that offers to create and 3D print your socket. Some c-fabs have specialized in creating 3D printed sockets using different printers and materials to manufacture sockets. If you are interested in this topic, have a look at our Interview with Joe Johnson, CEO of Quorum, right here >>
Pull your positive model in the Mecuris3D Creator tool and create a shell around your model. This shell could be printed in house on your own FDM printer or with a printing provider. Once the shell is printed it can be filled with plaster and you can continue with the socket in your lab using traditional methods.
A great aspect of using a digital approach when creating your positive model on the Mecuris Solution is that you can save up to 50 % of your manual working time. When eliminating the plastering process and using digital modification & measurements you are able to lower your cost of labor significantly.
💡 Are you keen on learning more? Then have a look at this Deep-Dive Webinar right here where Richard Miltenberger, CPO & clinical specialist, shows you these tools in action [watch recording for free | 20 min]
You want a personal demo of the tools on the Mecuris Solution Platform? You can see availabilities for a personal call right here.