How to make a prosthetic socket [myth buster]

It has been alleged by proponents of osseointegration that prosthetic socket making was a black art that orthopedic superconglomerates used in a conspiracy to make amputees dependent of stump sockets (commonly looked down upon as 'buckets') and ultimately suppress and exploit amputees - whereas osseointegration (getting a bolt put in the stump) would free amputees of any such dependency.

We have seen the words 'bucket sob' to refer to sweat accumulated in sockets - all nice and sweet but that opens up a whole new domain of dialog. If such words are used then I'd call the comprehensive lifestyle restrictions of osseointegrated people 'bolt fright'. Not wearing a normal weight prosthetic arm out of 'bolt fright'? Not coming to the public swimming pool out of 'bolt fright'? I mean, I do understand a little bit - with little children, old people and all of their bladder incontinence, the water may not always be super pristine...

Obviously, osseointegration - putting metal bolts into the bone stump(s) and have these stick out through the skin to attach a prosthesis to - makes you not at all 'less dependent'. At best osseointegration may help shift your dependency to a zone where you (but not necessarily others) may hopefully feel more comfortable - but whether that will be the case depends on your individual comfort zones, your ability to comply with the upkeep and cleanliness, and other factors including luck. Osseointegration also has specific risks and costs - for example, one bolt to be put into an arm costs around ~ 80'000 US$. Furthermore, osseointegration will make certain things outright impossible (as a formerly soft stump end now will permanently have an edgy protruding metal and you can never softly touch anyone any longer) and it will make other things difficult (as infection and mechanical breakage may quickly cause complications of a more serious nature).

So this moment, the original assumption - that the orthopedic establishment is using sockets as black art to make amputees dependent - requires some in depth myth busting.

Actually, anyone can build prosthetic sockets.

How to make a good prosthetic socket is something anyone who builds model airplanes, anyone who can buy do-it-yourself goods and anyone who has some time can easily tinker with and do. Besides, any normal prosthetic technician will interestedly accept self-built constructions that you show them, and learn from them. In my experience they never looked down on or laughed at a self-built or modified solution but instead tried to understand distinct advantages and later maybe implement them. Also they will happily use better components if they know where to get them and what to do with them, any time.

No conspiracy from where I'm standing.

Sockets come at relatively expensive prices maybe, but no conspiracy. And comparing a 3'500 US$ socket against an 80'000$ bolt that associates with a myriad of risks and complications, my bet is that sockets feel great and have good stability if they are built from modern materials by people that know what they are doing.

How to make sockets? Here's how.

Free Otto Bock PDF laminating instructions

Otto Bock makes these available for free (it really is not a conspiracy, believe me - get the instructions and make your own if you want):

Video instructions

How to turn a check or test socket (PET) into a laminated socket.

1) Removing a Temporary Socket from a Prosthesis Mold

First, a check socket is filled and molded with cast. After the cast hardened, the check socket is removed and destroyed in the process. The cast is used to build the final laminated socket.

Cite this article:
Wolf Schweitzer: Technical Below Elbow Amputee Issues - How to make a prosthetic socket [myth buster]; published 24/02/2010, 15:07; URL:

BibTeX: @MISC{schweitzer_wolf_1620291938, author = {Wolf Schweitzer}, title = {{Technical Below Elbow Amputee Issues - How to make a prosthetic socket [myth buster]}}, month = {February},year = {2010}, url = {}}