All About Stump Socks

Prosthetic socks can be used by leg and arm amputees to provide a more comfortable fit, reduce friction and absorb perspiration by "wicking" moisture away from the skin. Reducing perspiration on the skin can dramatically reduce bacterial infections and common skin complaints.

Some amputees wear socks in combination with sheaths or with liners to get the best possible fit, while others wear liners without socks. Some above-knee amputees have more tissue on their residual limb to provide padding and do not need a sock for added comfort, or they may be unable to wear one if wearing a standard suction socket (the stump has to directly contact this type of socket to work). We touch on a few options here - some may be more suitable than others. Check with your prosthetist to discuss what best suits you!

• What Does Ply Mean?
• What are They Made of?
• How Do I Wash Them?

What Does Ply Mean?

The "ply" refers to the number of strands used in the sock - if two strands are used the sock is "two-ply." The higher the number the thicker the sock. The "ply" can differ between materials - so if you are changing from a sock of one material to a new one of a different material you may need a different ply. Three-ply and five-ply are the most common thicknesses.

What are They Made of?

Socks are available in various materials:

• Wool - soft, full and absorbent. Now available in shrink-controlled and machine-washable yarn.
• Cotton - easy to care for, can be bleached. Does not wick moisture away from the skin as well as wool.
• CoolMax™ - new materials like Dupont's CoolMax draw moisture away from the skin and dry very quickly. Numerous manufacturers of socks now use this material in some of their products.
• X-static^® - made with a layer of pure silver which naturally inhibits the growth of bacteria.
• Other Materials - other fabrics offer other qualities, some are: nylon for strength, acrylic for softness, polyester for resiliency, rayon for absorbency and Lycra spandex for elasticity.

How Do I Wash Them?

Stump socks need to be washed every day - you may even need several different plys throughout the day if your stump changes in volume. Some can be machine-washed but others need to be washed by hand. A few tips:

• Make sure all soap is rinsed out to avoid irritation.
• Do not subject socks to excessive heat.
• To maintain the shape you can place a ball (same size as the sock) in the end of the sock.

The Road to Comfort is Paved With Liners

Most advancements in artificial limbs have traditionally focused on the "hardware" of an artificial limb such as knees, feet, elbows and hands. Little attention had been given to the "interface" - the point of contact between the residual limb and the artificial limb. That is until recently, with the arrival of liners.

Liners made of silicone, urethane, and other materials, provide greater comfort for amputees, and amputees report fewer skin abrasions. Liners come with or without a shuttle lock pin system, where the liner locks securely into the harder socket and is only released with the press of a button on the side of the socket.

Originally, locking liners were designed for below-knee amputees. Today, however, such liners are also used for above-knee amputees and arm amputees. Arm amputees find the great suspension an asset with recreational as well as standard fittings.

• What Are the Benefits of Wearing a Liner?
• What Are Some Other Points to Consider?
• What Types of Liners Are Available?

What Are the Benefits of Wearing a Liner?

What Are Some Other Points to Consider?

• Not all amputees are candidates for liners.
• The amputee may perspire excessively when first getting used to a liner - in most cases this subsides after an adjustment period, though that may take several months.
• Unless the flexible liner is compressible, the interface is still considered a hard socket and needs a sock to provide cushioning.
• Some liners tend to absorb bodily odours and perspiration; the wearer must be diligent in keeping the liner clean.
• Some amputees react to the silicone and other materials liners are made of and report skin problems such as contact dermatitis; however, other factors such as the use of creams or powders in the socket may contribute to this.
• Some liners can roll down into the leg and require straightening.

What Types of Liners Are Available?

Many manufacturers of prosthetic products have their own versions of liners including ones with and without shuttle pin locks:

• Aegis (Engineered Silicone Products) - is a tapered silicone liner which closely follows the true anatomical shape of a residual limb. It is comfortable and has minimal wrinkling when you are seated for extended periods.
• Alpha Cushion and Locking Liners (Ohio Willow Wood) - these silicone-free gel liners are covered in a Spandex-like material and are infused with skin-conditioning mineral oil, eliminating the need for powders or lotions when putting the liner on.
• Iceross (Ossur) - the newer Iceross Comfort is made with medical-grade SenSil silicone gel and is covered with highly elastic fabric. Iceross Distal Cups can be used with a standard Iceross for conicial/short residual limbs.
• OrthoGel Liner (Otto Bock) - the liner is made of polyurethane gel and a reinforced fabric cover. The inside of the liner is coated to make it easy to put on and take off without using any lubricants.
• Silicone Arm Liner (Otto Bock) - this silicone liner, specifically for arm amputees, gives improved suspension and allows an increase in range of motion around the elbow joint. The shuttle system is suitable even for longer below-elbow amputees. Currently available in four sizes.
• Silipos Gel Liner and SiloLiner (Silipos) - this gel liner incorporates medical-grade mineral oil in the nylon material. SiloLiner is suitable for those with very active lifestyles.
• TEC Liners (Otto Bock) - these silicone-free urethane liners function on the same principle as the human heel pad which dissipates pressures common in high level activities.