Under normal circumstances suspension of a limb is carried out by ligaments, which attach bone to bone, and by tendons, which attach muscles to bone within the limb. Clearly after a leg or arm amputation the prosthetic limb has to be fitted and attached in such a way that it does not fall off. Suspension of the prosthesis is therefore crucial to the amputee’s confidence.

Numerous ways have been devised in which to suspend a prosthetic device. Before 1958, the thigh corset combined with a waist belt was undoubtedly the most common form of transtibial prosthetic suspension. Modern materials have meant the introduction of silicone sleeves which fit snugly to the stump and are connected to the lower part of the prosthesis with a pin system. Ossur. An Icelandic company, has recently introduced a “seal-in-liner”, which incorporates a very strong vacuum between the stump and the prosthetic limb. The prosthesis is removed after releasing the vacuum with a button.

WillowWood, an Ohio company, manufacture a series of, Alpha® Liners, which are thermoplastic elastomer liners which gently cling to skin, protecting it from abrasion and breakdown. The gel in these liners contains mineral oil and vitamin E, making them skin-friendly and comfortable to wear. There are Alpha® Liners designed for both above and below knee amputations. In a similar way to Ossur’s liners, the vacuum seal is released by means of a one-way valve.