Photographs of the quadrilateral socket brim, courtesy of NUPOC.
Northwestern University Prosthetics-Orthotics Center (NUPOC) has donated two sets of A. J. Hosmer quadrilateral brims to two O&P training programs: the Br. Tarcisius Prosthetics & Orthotics Training College, part of the Orthopedic Training Centre in Nsawam, Ghana, and the Philippine School of Prosthetics and Orthotics, which offers a bachelor of science in O&P at the College of Allied Rehabilitation Sciences, University of the East-Ramon Magsaysay Memorial Medical Center, Quezon City, Manila.
The quadrilateral socket was introduced in the 1950s and clinically available through the 1960s, but ischial containment sockets are more commonly provided in the United States. A quadrilateral brim enables a practitioner to produce a cast that requires few modifications while providing a reliable, total-contact transfemoral prosthetic socket. The quadrilateral socket brims, developed by Charles Radcliffe, are made of aluminum in a range of sizes for right and left residual limbs. The sleeve-like structure creates a pre-shaped Scarpa’s triangle and provides a shelf for weight bearing at the ischial tuberosity. The wall of the sleeve is split to increase or decrease the anterior to posterior measurement and overall circumference.
For casting, the patient places his residual limb into the brim sleeve that is supported by a vertical stand and is cast while standing and bearing weight on the posterior brim. The practitioner wraps plaster bandage over the residual limb, including the brim that defines the soft-tissue of the thigh into a quadrilateral shape. The brim becomes part of the negative mold and is removed, cleaned, and reused after pouring the positive mold.
Editor’s note: This story was adapted from materials provided by NUPOC.
