1008 - Design and fabrication of a novel transfemoral prosthetic adaptation for the para-equestrian

Case Diagnosis: Right transfemoral amputation

Case Description: 70-year-old 5’0” female with a right transfemoral amputation secondary to sarcoma, K3 level ambulator, accomplished former equestrian. Due to her small stature the patient was unable to ride with her daily prosthesis. In order to continue riding, she was prescribed a custom molded sub-ischial co-polymer riding socket with a cushioned distal end. This is the first known use of this type of riding socket. Compared to a non-custom leather holster type device, this socket design is intended to maximize para-equestrian comfort and stability and minimize skin breakdown.

Discussions: Para-equestrian sport has evolved into an internationally-recognized event held as part of the Paralympics. Despite this, data concerning the technical characteristics and special mechanical properties of prosthetic adaptations for equestrianism is scarce. Described adaptive equipment-aids range from saddle modifications to modified lower limb prosthetics termed riding legs. Transfemoral riding legs typically lock the knee in a flexed position. However, a very short residual limb or pressure points in the socket may be reasons to ride without an artificial limb. In these circumstances, para-riders may opt to use a non-custom leather holster type device. These devices typically consist of a cup in the configuration of a hollow, truncated, open topped, right circular cone. In contrast, this novel design utilizes a sub-ischial copolymer socket molded to the rider’s unique limb.

Conclusions: To our knowledge, this report represents the first case in the literature of a custom sub-ischial co-polymer riding socket. Use of this design compared to a non-custom leather holster type device is intended to maximize para-equestrian comfort and stability and minimize skin breakdown. Additional studies assessing technical characteristics and special mechanical properties of prosthetic adaptations for the para-equestrian and other para-athletes are needed to facilitate the achievement of peak performance without causing significant risk of injury.