Adjustable Pediatric Prosthetic Sockets to Accommodate Growth in Children and Adolescents With Limb Loss.

OBJECTIVE: To evaluate the feasibility, comfort, user satisfaction, and functional performance of an adjustable, immediate-fit prosthetic socket in children and adolescents with lower-limb loss. DESIGN: Prospective clinical trial. SETTING: Gait and biomechanics lab in an outpatient rehabilitation hospital. PARTICIPANTS: Twenty-eight pediatric participants (14 boys, 14 girls; average age 11.5±4.0y) were enrolled; 26 were eligible for the home trial. INTERVENTION: Each participant was fit with an adjustable, immediate-fit prosthesis, which was compared with the users' conventional devices. MAIN OUTCOME MEASURES: Prosthetic Evaluation Questionnaire (PEQ) scores (use and satisfaction) with additional items on comfort; temporal gait parameters (gait speed, single-limb support); intrasocket pressure measurements; and adverse events (falls, skin irritation, device issues). RESULTS: Fifteen participants completed follow-up. Overall PEQ scores favored the adjustable device, although not significantly (45.8 vs 42.5, P=.29). Ease of socket adjustment demonstrated a significant advantage for the adjustable prosthesis (mean difference=1.53, P=.0019). Participants also reported improved temperature and perspiration control (mean difference=1.07, P=.0007). Walking speed did not differ between devices (P=.24), and intrasocket pressures were comparable (P=.74). No skin irritation, skin breakdown, or mechanical failures were observed or reported. CONCLUSIONS: The adjustable, immediate-fit pediatric prosthetic system was feasible and well accepted. It performed comparably with conventional devices on gait and pressure metrics and demonstrated ease of use and improvements in factors associated with skin integrity. These findings suggest that adjustable sockets may offer a practical, affordable alternative for children and families seeking a device that can accommodate growth.