Course of soft tissue injuries in the transtibial amputation residuum

A transtibial amputation (ITA) prosthetic user has to deal with daily complications associated with his artificial limb. Though highly progressed, technologically and functionally, the TTA prosthesis is far from ideally replacing an intact limb, mainly due to unique inherent anatomy. After a long and complicated fitting process, the prosthetic limb is often a source of gait abnormalities, limb pain and soft tissue breakdown. While commercial prosthetic accessories and aids are plentiful, tools that analyze the mechanical conditions in the soft tissues of the residual limb during load-bearing are scarce. Therefore, clinicians are not well-equipped with tools that are able to quantify the effectiveness of socket rectification and the use of aids, e.g. liners and thigh corset. In this review we will discuss TTA aetiology and elaborate on the prostheses that are most commonly used today. We will also review gait characteristic and its associated complications. Mainly, we will discuss socket limb interaction and methods for quantifying the internal mechanical conditions in the residual limb for the purpose of preventing deep tissue injuries.