Understanding Prosthetic Suspension Options: A Guide for Upper and Lower Limb Prosthetics

When it comes to prosthetics, the suspension system is one of the most important factors in determining comfort, stability, and control. Suspension is just how the prosthetic (fake part) is attached to the residual limb (real part), keeping it securely in place. With so many options available, it’s crucial to choose the right one based on your needs, whether you’re using an upper or lower limb prosthesis. In this post, we'll break down the most common suspension systems for both upper and lower limb amputees and discuss the pros and cons of each.

Upper Limb Prosthetic Suspension Options

1. Suction Suspension

Suction suspension uses a seal between the prosthetic socket and the residual limb, creating a vacuum that holds the prosthesis in place. A valve releases air when putting the prosthesis on and maintains the vacuum during use.

Pros:

- Secure fit with little movement, which improves control

- No straps or additional harnessing required

- More natural feel and appearance

Cons:

- Requires a well-shaped and stable residual limb for a proper fit

- Sweating can affect the seal and cause slippage

- Can be difficult to don/doff (put on/take off), especially for new users

2. Pin Lock Suspension

In this system, a liner with a locking pin at the end is rolled onto the residual limb. The pin clicks into a lock at the bottom of the prosthetic socket, securing the limb in place.

Pros:

- Easy to don and doff, making it a popular option for new users

- Provides a secure fit

- Doesn’t rely on suction, so less affected by sweating

Cons:

- Some movement or “pistoning” can occur, leading to irritation

- May cause pressure at the distal end of the limb (where the pin attaches)

A harness system uses straps that go around the shoulders or torso to hold the prosthetic in place. The tension in the harness is adjusted for a secure fit.

3. Harness Suspension

Pros:

- Effective for short or uneven residual limbs where other suspensions may not work

- Provides stability and control

- Can be combined with body-powered prostheses for better function

Cons:

- May be uncomfortable or restrictive due to the harness system

- Bulky appearance and less cosmetic appeal

- Straps may cause discomfort or skin irritation over time

One way that I have been able to try out different suspension systems, and even socket styles is by participating in research! I get custom devices built for me that are completely paid for by the researchers! If you want to get involved in research click here!

Lower Limb Prosthetic Suspension Options

1. Suction Suspension

Like with upper limb prosthetics, suction suspension for lower limbs creates a vacuum seal that holds the prosthetic in place. It’s one of the most popular choices for below-knee prostheses.

Pros:

- Secure, stable fit with minimal movement

- Helps reduce pressure points by distributing weight evenly

- No straps or external suspension needed

Cons:

- Residual limb must be well-shaped and properly sized for a tight fit

- Sweating can break the seal, causing slippage

- Can be tricky to put on, especially for those with reduced hand function

2. Vacuum-Assisted Suspension (VAS)

This option builds on the suction system but adds a pump that actively maintains the vacuum. This provides an even tighter seal between the socket and the limb.

Pros:

- Provides excellent stability and reduces movement between the limb and socket

- Improves circulation in the residual limb

- Good for people who experience volume changes in their limb throughout the day

Cons:

- Can be expensive due to the added technology

- Requires regular maintenance to ensure the vacuum pump works effectively

- Can be bulky or heavy compared to simpler systems

3. Pin Lock Suspension

Similar to the upper limb version, pin lock suspension for lower limbs uses a liner with a locking pin at the end that secures the limb to the prosthetic socket. (this is what I use)

Pros:

- Easy to put on and take off

- Secure fit with minimal effort

- Common and widely available, making replacements or adjustments easier

Cons:

- May cause “pistoning” (the limb moving up and down inside the socket), leading to discomfort or irritation

- Locking pin can create pressure at the distal end of the limb

- Not ideal for people with sensitive or bony residual limbs

4. Neoprene Sleeve Suspension

The neoprene sleeve fits snugly over the prosthesis and the residual limb, using friction to keep the prosthetic in place. This system is often used in combination with other suspension methods.

Pros:

- Easy to don/doff and adjust throughout the day

- Comfortable for everyday use

- Provides a more natural appearance as the sleeve blends in with the skin

Cons:

- Less secure than suction or pin lock systems

- The sleeve may stretch over time, reducing effectiveness

- Can be hot and cause sweating, leading to discomfort

5. Elevated Vacuum Suspension

An elevated vacuum suspension system uses an electronic or mechanical pump to remove air between the socket and the liner, creating a vacuum that holds the prosthesis in place.

Pros:

- Best option for reducing movement between the socket and limb

- Improves control and function, making it ideal for active users

- Helps reduce skin irritation by ensuring a constant fit

Cons:

- Expensive and requires more maintenance than simpler systems

- The pump can add extra weight and bulk to the prosthesis

- Battery-powered pumps may need regular charging or replacement

Choosing the Right Suspension System

When selecting the best suspension system for your prosthesis, consider factors like comfort, ease of use, your activity level, and the shape of your residual limb. Consult with your prosthetist, who will evaluate your specific needs and guide you in making the right choice.

Remember, the best system is the one that fits your lifestyle and allows you to live as actively and comfortably as possible. Whether you need upper or lower limb suspension, there’s a solution that can meet your needs and keep you moving forward.

By understanding these suspension options, you’ll be better equipped to make an informed decision about your prosthetic care, leading to a more comfortable and functional experience with your device.

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