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Abstract
This research was designed as an applied single-case study aimed at evaluating the technical and economic feasibility of fabricating a transfemoral socket for an individual with a right-sided transfemoral amputation using affordable equipment. The proposed workflow combined traditional manual techniques with computer-aided design and manufacturing (CAD-CAM), 3D scanning, and additive manufacturing. Because the available 3D scanner could not directly capture the residual limb in the standing position due to obstruction from the contralateral limb, a hybrid approach was implemented. A negative mold and a positive plaster model of the residual limb were first produced using manual techniques, and the resulting positive model was scanned and modified to design the socket using Blender. A PLA socket was initially manufactured for preliminary fitting and comfort tests, followed by the fabrication of the final socket using ABS filament. The socket was assembled with the existing prosthetic components and underwent preliminary test of fit, suspension, and ambulation. Subjective evaluations indicated acceptable-to-good results, and the prototype allowed preliminary ambulation under supervision; slight pistoning was observed during the swing phase. The total fabrication cost was USD 42.77, considering materials and electrical energy, while equipment acquisition and labor were not included. These results indicate the preliminary technical feasibility of combining manual and digital techniques to fabricate a transfemoral socket using affordable resources. However, the prototype requires further mechanical, functional, and clinical evaluation before being considered for routine daily use.
References
Berke, G. M., Buell, N. C., Fergason, J. R., Gailey, R. S., Hafner, B. J., Hubbard, S. M., Smith, D. G., & Willingham, L. L. (2008). Transfemoral amputation: The basics and beyond. Prosthetics Research Study.
Blender Foundation. (s.f.). About Blender. https://www.blender.org/about/
Broche Vázquez, L., Torres Quezada, M., Díaz Novo, C., Pérez Bonne, P., & Sagaró Zamora, R. (2015). Influencia de la asimetría de la marcha en el comportamiento biomecánico de las articulaciones de cadera en pacientes con prótesis transfemorales. Ingeniare. Revista chilena de ingeniería, 23(2), 312–322. https://doi.org/10.4067/S0718-33052015000200016
Cagle, J. C., Hafner, B. J., & Sanders, J. E. (2018). Characterization of prosthetic liner products for people with transtibial amputation. Journal of Prosthetics and Orthotics, 30(4), 187–199. https://doi.org/10.1097/JPO.0000000000000205
Chong, S.-Y., & Röhrle, O. (2016). Exploring the use of non-image-based ultrasound to detect the position of the residual femur within a stump. PLOS ONE, 11(10), e0164583. https://doi.org/10.1371/journal.pone.0164583
De Vivo Nicoloso, L. G., Pelz, J., Barrack, H., & Kuester, F. (2021). Towards 3D printing of a monocoque transtibial prosthesis using a bio-inspired design workflow. Rapid Prototyping Journal, 27(11), 67–80. https://doi.org/10.1108/RPJ-06-2021-0136
Dickinson, A., Diment, L., Morris, R., Pearson, E., Hannett, D., & Steer, J. (2021). Characterising residual limb morphology and prosthetic socket design based on expert clinician practice. Prosthesis, 3(4), 280–299. https://doi.org/10.3390/prosthesis3040027
Gholizadeh, H., Abu Osman, N. A., Kamyab, M., Eshraghi, A., Lúðvíksdóttir, Á. G., & Wan Abas, W. A. B. (2012). Clinical evaluation of two prosthetic suspension systems in a bilateral transtibial amputee. American Journal of Physical Medicine & Rehabilitation, 91(10), 894–898. https://doi.org/10.1097/PHM.0b013e31823c74d7
Girijala, R. L., & Bush, R. L. (2018). Review of socioeconomic disparities in lower extremity amputations: A continuing healthcare problem in the United States. Cureus, 10(10). https://doi.org/10.7759/cureus.3418
Kahle, J., Miro, R. M., Ho, L. T., Porter, M., Lura, D. J., Carey, S. L., Lunseth, P., Highsmith, J., & Highsmith, M. J. (2020). The effect of the transfemoral prosthetic socket interface designs on skeletal motion and socket comfort: A randomized clinical trial. Prosthetics and Orthotics International, 44(3), 145–154. https://doi.org/10.1177/0309364620913459
Kılınç Kamacı, G., & Aydemir, K. (2023). Lower limb prosthetic prescription. Turkish Journal of Physical Medicine and Rehabilitation, 69(4), 391–399. https://doi.org/10.5606/tftrd.2023.12988
López Gualdrón, C. I., Bautista Rojas, L. E., & Machuca Gelvez, J. A. (2019). Reconstrucción 3D para el desarrollo de prótesis de miembro inferior. Revista UIS Ingenierías, 19(1), 73–86. https://doi.org/10.18273/revuin.v19n1-2020007
Muller, M. D. (2016). Transfemoral amputation: Prosthetic management. En J. I. Krajbich, M. S. Pinzur, B. K. Potter, & P. M. Stevens, (eds.). Atlas of amputations and limb deficiencies: Surgical, prosthetic, and rehabilitation principles (pp. 537–554). American Academy of Orthopaedic Surgeons.
Oldfrey, B. M., Morgado Ramirez, D. Z., Miodownik, M., Wassall, M., Ramstrand, N., Wong, M. S., Danemayer, J., Dickinson, A., Kenney, L., Nester, C., Lemaire, E., Gholizadeth, H., Diment, L. E., Donovan-Hall, M. K., & Holloway, C. (2024). A scoping review of digital fabrication techniques applied to prosthetics and orthotics: Part 1 of 2—prosthetics. Prosthetics and Orthotics International, 48(5), 574–589. https://doi.org/10.1097/PXR.0000000000000351
Paternò, L., Ibrahimi, M., Rosini, E., Menfi, G., Monaco, V., Gruppioni, E., Ricotti, L., & Menciassi, A. (2021). Residual limb volume fluctuations in transfemoral amputees. Scientific Reports, 11. https://doi.org/10.1038/s41598-021-91647-9
Pino, A. J., Bernal, C. M., Gavidia, L., & Diaz, R. E. (2023). Diseño y fabricación de cuenca transfemoral de contención isquiática para prótesis de miembro inferior mediante el uso de tecnologías disruptivas. AXIOMA, (28), 38–49. https://doi.org/10.26621/ra.v1i28.857
Protolabs. (s.f.). ABS plastic: Understand the key benefits and applications. https://www.protolabs.com/materials/abs/
Tiesler, L. M., Edel, M., Wang, F., Pieroh, P., Drossel, W.-G., Carabello, A., Zipplies, D., Heyde, C.-E., & Schleifenbaum, S. (2025). Objective measurement methods for the evaluation of socket comfort in patients with transfemoral amputation: A systematic review. Frontiers in Bioengineering and Biotechnology, 13. https://doi.org/10.3389/fbioe.2025.1576729
van Gastel, P., Sterkenburg, I. P., Smit, G., van der Stelt, M., & Leijendekkers, R. (2026). Comparisons of (cost-)effectiveness of manual, hybrid, and digital shape capture and shape design techniques for transtibial and transfemoral prosthetic sockets: A scoping review. Prosthetics and Orthotics International, 50(4), 491–503. https://doi.org/10.1097/PXR.0000000000000531
Young, P. R., Hebert, J. S., Marasco, P. D., Carey, J. P., & Schofield, J. S. (2023). Advances in the measurement of prosthetic socket interface mechanics: A review of technology, techniques, and a 20-year update. Expert Review of Medical Devices, 20(9), 729–739. https://doi.org/10.1080/17434440.2023.2244418
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