Cast Socks

Types of prosthetic cast socks
Prosthetic cast socks are available in different types depending on thickness and type of material used to make them. Thickness of this type of socks is measured in terms of a rating "ply" hence the following types exist:

Single ply socks

These are the thinnest type of prosthetic cast socks available with a single thickness.

Multiple ply socks

For these types of socks, thickness is either 2, 3 4 5 or 6 one-ply socks. This thickness can also be attained by wearing more than one single ply socks. For instance, wearing a two one –ply prosthetic cast socks will be like wearing a single two-ply sock and wearing a two 5-ply prosthetic cast socks will be like wearing a 10-ply sock and so on.

As the volume of your residual limb decreases in the course of the day, it is recommended to add extra socks to ensure the socket is well fitting. This can be attained either by adding an extra sock or removing the entire sock and replacing them with one with the desirable thickness.

Depending on the material used, the following types of prosthetic cast socks exist

Wool cast socks

Wool is a highly preferred fiber for its resilient, absorbency and conformability characteristics. Its resiliency provides enough cushions to the wearer and hence maximum comfort can be attained. Its high degree of absorbency on the other hand makes it the best option to be considered for all weather as it easily absorbs perspiration in the hot weather and provides warmth during the cold and humid weather conditions. With the different shapes of residual limbs, wool sure provides a better fit for the contours without wrinkling.

Synthetic fibers
Examples of synthetic fibers used in prosthetic cast socks include polypropylene and Lycra. a combination of synthetic and non-synthetic fiber may also be used with an added advantage in taking away perspiration and transporting it across the fiber and away from the skin. Lycra is preferred for its elastic nature hence useful in accommodating edema or atrophy more easily. Wool has in the recent years been used in combination with synthetic fibers providing an extra advantage in its smooth texture and elastic nature while at the same time resisting shrinking and felting. Cast socks made with both fibers are also cheaper to purchase than the wool fibered cast socks.

Nylon sheaths
This type of material is constructed at the distal end and offers an advantage in moisture and friction regulation between the skin, sock and prosthesis.

Uses of prosthetic cast socks

• They provide cushion to the residual limb
• They help in absorbing and reducing friction
• They protect the skin
• They absorb perspiration
• They serve to compensate for shrinking or swelling of the residual limb

When you need to use prosthetic cast socks
As your residual limb matures, you will realize the need to use prosthetic cast socks. This is due to the changes in shape and size of the residual limb. It will therefore be necessary for you to own and adjust these socks.

When to add prosthetic cast socks

In the case of shrinkage of the residual limb, you will be required to add socks. The following will signal you on when to add an extra sock: Below-the-Knee (BK) Amputee

• A feeling of the socket pushing up under your knee cap
• Red mark on your knee cap may be observed
• A feeling of the residual limb end hitting the bottom of the socket
• A feeling that the prosthesis is short

Above-the-Knee (AK) Amputee

• Pressure in the groin area
• A feeling of the residual limb end hitting the bottom of the socket
• A feeling that the prosthesis is short
• In case you observe any of the above signs, it is recommended that you immediately put an extra ply sock. Add one ply sock at a time until the desired comfort is attained

When to subtract prosthetic cast socks

Swelling of the residual limb is the major factor that causes the need to subtract prosthetic cast socks. This swelling may occur as a result of the following:

• Weather changes
• When you have not worn your shrinker
• Gain or loss of body weight
• Therefore, subtract your sock in case of the following:

Below- the Knee (BK) Amputee

• Pressure from the bar in the socket of your legs shin
• Red mark on your legs shin
• A Residual limb end is not touching the sockets bottom
• The prosthesis feels tall

Above-the-Knee (AK) Amputee

• Pressure of your bone on the prosthesis, that is, feeling like your "sit bone" is sitting on the prosthesis
• A residual limbs end is not touching the sockets bottom
• Managing prosthetic cast socks

To effectively manage your prosthetic cast socks and hence realize more benefits from using them, the following practices should be observed:

Apply multiple ply socks rather than the single ply socks. This means that you should for instance apply two 2- ply socks rather than a single 4-ply sock. This is because it will be much easier to detect any discomfort and manage it if you have multiple ply socks.

Apply prosthetic cast socks carefully to avoid wrinkles. This should be done with special focus at the back of your leg. It is recommended that you wear clean and dry socks. This is because dirty socks will increase chances of infection by attracting bacteria which eventually cause skin rash. On the other hand, wet socks cause skin maceration, that is, your skin will soften and break down due to the prolonged exposure to moisture. Therefore, socks should be machine washed with mild soap and warm water. They should also be air dried to avoid shrinking. Moreover, you should rotate your socks on a three or four day schedule to allow the fibers retain their original position.

It is also recommended that you change your socks at least once a day especially in the afternoon during the warm, humid weather. This is because during such weather conditions, these socks tend to absorb sweat and dirt hence distorting the socket fit.