Vaughan Thesis

Copyright
by
Meagan Renee Vaughan
2009
The Thesis Committee for Meagan Renee Vaughan
Certifies that this is the approved version of the following thesis:
Design and Analysis of a Volume Adjustable Transtibial Prosthetic

Socket for Pediatric Amputees in Developing Countries
APPROVED BY
SUPERVISING COMMITTEE:
Supervisor:
Richard H. Crawford
Carolyn C. Seepersad
by
Meagan Renee Vaughan, BS
Thesis
Presented to the Faculty of the Graduate School of
The University of Texas at Austin
in Partial Fulfillment
of the Requirements
for the Degree of
Master of Science in Engineering
The University of Texas at Austin

December, 2009
Acknowledgements
This thesis is the product of many hours of work supported by my God, family,
friends, and colleagues at UT. Thank you all!
I would like to particularly acknowledge John T. Montgomery and Dr. Richard
Crawford who helped me complete and give direction to my research. I would also like to
thank the members of the LEGS program at LeTourneau University that helped inspire
me to do this research in the first place.
iv
Abstract

Meagan Renee Vaughan, MSE

The University of Texas at Austin, 2009
Supervisor: Richard H. Crawford
For pediatric amputees in developing countries, where characteristically rapid

growth of children is compounded by a lack of medical services, maintaining proper
socket fit is a challenging but necessary endeavor. A socket design that adjusts for radial
and longitudinal growth will allow patients to wear the same socket for a longer period of
time saving them the expense of subsequent fittings and hardware. Manufacture of such a
socket poses a challenge for contemporary manufacturing processes. Due to its ability to
rapidly manufacture complex part geometries, Selective Laser Sintering (SLS) is
particularly suited to this application. Several preliminary design concepts for a volume
adjustable transtibial SLS prosthetic socket for pediatric amputees in developing
countries have been generated. These current design concepts utilize fasteners such as
ratchet hooks and threads. Results from design and validation of theoretical models of
these fastener concepts are the focus of this thesis.
v
Table of Contents
List of Tables.........................................................................................................viii 
List of Figures.........................................................................................................ix 
Chapter 1: Introduction...........................................................................................1 
Chapter 2: Background ...........................................................................................3 

Prosthetic Sockets...........................................................................................3 
General Case Needs........................................................................................9 
Developing Countries ...................................................................................14 
Additive Manufacturing................................................................................16 
Problem Statement........................................................................................19 
Potential Impact ............................................................................................19 
Chapter 3: Proposed Solution Requirements ........................................................21 

Sources for Customer Needs Analysis .........................................................21 
Specification Sheet .......................................................................................22 
Manufacturing Requirements .......................................................................24 
Biomedical and Biomechanical Requirements.............................................24 
Adjustability .................................................................................................25 
Actuation.......................................................................................................27 
Robustness ....................................................................................................28 
Additional User Requirements .....................................................................30 
Chapter 4: Design Solution Concept Generation..................................................32 

Concept Generation Methods .......................................................................32 
Generated Concepts ......................................................................................38 
Conclusion ....................................................................................................51 
Chapter 5: Concept Selection................................................................................52 

Radial Change...............................................................................................53 
Longitudinal Change ....................................................................................55 
vi
Fasteners .......................................................................................................57 
Interface with Socket Components...............................................................59 
Safety and Aesthetics....................................................................................60 
Concepts Selected for Further Development................................................60 
Chapter 6: Design Embodiment and Verification Results.....................................62 

Threaded Fastener Development ..................................................................62 
Ratchet Fastener Development .....................................................................76 
Conclusion ....................................................................................................96 
Chapter 7: Discussion ...........................................................................................97 

Geometric Accuracy .....................................................................................97 
Load Capacity.............................................................................................100 
Model Accuracy..........................................................................................103 
Application of Results ................................................................................104 
Chapter 8: Conclusion.........................................................................................106 
References............................................................................................................110 
Vita.......................................................................................................................116 
vii
List of Tables
Table 1: Causes of Amputation for Developed and Developing countries .........................4 
Table 2: Specification Sheet ..............................................................................................23 
Table 3: Analogies Considered for Actuation Mechanisms Pertaining to Children .........34 
Table 4: Concept Word Generation Results ......................................................................37 
Table 5: Radial Change Selection Criteria and Rating Scale ............................................54 
Table 6: Radial Change Elimination Matrix......................................................................55 
Table 7: Longitudinal Change Selection Criteria and Ranking Scale ...............................56 
Table 8: Longitudinal Change Elimination Matrix ...........................................................57 
Table 9: Fastener Selection Criteria and Ranking Scale ...................................................58 
Table 10: Fastener Elimination Matrix..............................................................................58 
Table 11: Socket Interface Selection Criteria and Ranking Scale.....................................59 
Table 12: Socket Interface Elimination Matrix .................................................................60 
Table 13: Threaded Fastener Specimen Dimensions.........................................................65 
Table 14: Material Property Results - Test Build 1...........................................................69 
Table 15: Threaded Model Results....................................................................................70 
Table 16: Final Threaded Specimen Dimensions..............................................................72 
Table 17: Material Property Results - Test Build 2...........................................................75 
Table 18: Redesigned Threaded Fastener Model Results..................................................76 
Table 19: Ratchet Specimen Dimensions ..........................................................................78 
Table 20:Anticipated Extension and Load on Ratchet Specimens Based on FEA............82 
Table 21: Redesigned Ratchet Dimensions .......................................................................88 
Table 22: Anticipated Extension and Stress on Redesigned Ratchet Specimen Based on
FEA............................................................................................................................89 
Table 23: Rotated Redesigned Ratchet Specimen .............................................................90 
viii
List of Figures
Figure 1: Basic Lower Limb Prosthetic Components..........................................................5 
Figure 2: Early Transtibial Prosthetic Limb Designs ..........................................................6 
Figure 3: Patella Tendon Bearing Socket Design................................................................7 
Figure 4: Pressure Distribution of Hydrostatic Socket ........................................................8 
Figure 5: Previous SLS Compliant Sockets from UT Austin............................................18 
Figure 6: Comparison of Additive Manufacturing Processes to Tensile Strength ............29 
Figure 7: Pyramid Style Adapter Components..................................................................30 
Figure 8: Pipe Clamp Example..........................................................................................33 
Figure 9: Aperture Design Concept (Top View) ...............................................................39 
Figure 10: Internal Sliding Plates Design Concept (Top View)........................................39 
Figure 11: Possible Pipe Clap Design Concept .................................................................40 
Figure 12: Removable Wall Design Concept ....................................................................41 
Figure 13: Plunger Longitudinal Height Adjustment Concept..........................................43 
Figure 14: Interlocking Rings Design Concept .................................................................43 
Figure 15: Threaded Wall Design Concept .......................................................................44 
Figure 16: Set Screw with Through Holes Pylon Adjustment ..........................................45 
Figure 17: Existing Integrated Mounting Plate Designs ...................................................46 
Figure 18: Monolimb Socket Design Example .................................................................47 
Figure 19: Hinge Fastener Design Concept.......................................................................47 
Figure 20: Screw Expander Design Concept.....................................................................48 
Figure 21: Horizontal Bands Design Concept ...................................................................49 
Figure 22: Ratchet Design Concept (Top View) ...............................................................49 
Figure 23: Existing Actuated (17.a) and Thin Walled (17.b) Compliant Region Designs51 
Figure 24: Basic Threaded Specimen Geometry ...............................................................62 
Figure 25: Final Threaded Specimen.................................................................................66 
Figure 26: Threaded Specimen Testing Setup...................................................................67 
Figure 27: Geometric Accuracy of Threaded Fasteners ....................................................68 
Figure 28: Load vs. Extension – Initial Threaded Specimens ...........................................69 
Figure 29: Redesigned Threaded Specimens.....................................................................71 
Figure 30: Geometric Accuracy of Redesigned Threaded Fasteners ................................72 
Figure 31: Threaded Fastener Load vs. Extension Curve - Sample Set D ........................73 
Figure 32: Threaded Fastener Load vs. Extension Curves - Sample Set E .......................74 
Figure 33: Threaded Fastener Load vs. Extension Curves - Sample Set F .......................74 
Figure 34: Basic Ratchet Specimen Geometry..................................................................77 
Figure 35: Ratchet Sample Design Iteration (Bottom Final).............................................78 
Figure 36: Ratchet Specimen Tensile Testing Setup.........................................................79 
Figure 37: Constrained Ratchet FEM ................................................................................80 
Figure 38: Example Convergence Plot ..............................................................................80 
Figure 39: Geometric Accuracy of Ratchet Fasteners.......................................................83 
Figure 40: Sample Experimental Load vs. Extension Curve (30 Deg Internal Angle
Ratchet Specimens) ...................................................................................................84 
ix
Figure 41: Load vs. Tooth Thickness (Left) and Angle (Right)........................................82 
Figure 42: Comparison of Ratchet Theoretical Strength Model to Experimental Data -
Range of Tooth Thicknesses (1, 1.25, and 1.5 mm) ..................................................85 
Range of Ratchet Internal Tooth Angles (25, 30, and 35 Degrees)...........................86 
Figure 44: Relative Percent Difference of Ratchet FEM Results from Experimental Data
vs. Load (Load at yield circled).................................................................................87 
Figure 45: Redesigned Ratchet Specimen Geometry ........................................................88 
Figure 46: Rotated Redesigned Ratchet Specimen Geometry...........................................90 
Figure 47: Geometric Accuracy - Redesign (Left) and Rotated Redesign (Right) ...........89 
Figure 48: Load Capacity of the Redesign Ratchet vs. Angle (Left) and Fillet Diameter
(Right)........................................................................................................................92 
Figure 49: Load Capacity of the Rotated Redesign Ratchet vs. Angle (Left) and Fillet
Diameter (Right)........................................................................................................90 
Figure 50: Comparison of Redesigned Ratchet Theoretical Strength Model to
Experimental Data - Range of Fillet Radii (0.25, 0.5, and 0.75 mm)........................93 
Experimental Data - Range of Internal Tooth Angles (25, 30, and 35 deg)..............94 
Figure 52: Relative Percent Difference of Redesigned Ratchet FEM Results from
Experimental (Load at yield circled) .........................................................................95 
Figure 53: Comparison of Rotated Ratchet Theoretical and Experimental Results..........96 
Figure 54: Gap in Teeth of Mating Ratchet Specimens ....................................................99 
Figure 55: Deformation of Threaded Specimen Pull Tabs..............................................100 
Figure 56: Example of Initial Unloaded Region of Threaded Specimen Load vs.
Extension Curve.......................................................................................................101 
Figure 57: Possible Threaded Fastener Implementation .................................................104 
Figure 58: Possible Ratchet Fastener Implementation ....................................................105 
x
Chapter 1: Introduction
Proper design of a prosthetic socket component is critically important to an

amputee’s comfort and mobility. This artificial limb component provides the primary
interface between the residual limb and the remainder of the prosthesis. Therefore, any
failure of the socket to perform this function restricts the ability of the prosthesis to
increase the mobility of the user. In addition to misalignment and improper initial fittings,
changes in the volume, both radial and longitudinal, of the patient’s residual limb are a
primary contributor to the degradation of proper socket fit. This risk of wearing a
prosthetic socket with poor fit is greater for pediatric amputees who must balance the
financial and logistical impact of replacing their socket with increased rates of volumetric
change characteristic of growth. With limited availability of appropriate technology,
those patients located in low-income countries are impacted even more by this difficulty
of maintaining proper socket fit. A new socket design is therefore needed that provides a
robust design that can be used for a greater period of time by adjusting to the volumetric
changes inherent in normal pediatric growth patters both radially and longitudinally.
Manufacture of such a socket poses a challenge for contemporary fabrication
technologies. Due to its ability to rapidly manufacture complex part geometries, Selective
Laser Sintering (SLS) is particularly suited to this application. This thesis therefore
documents the process utilized in designing an adjustable transtibial (below knee)
prosthetic socket design for pediatric amputees in developing countries. In particular, the
following stages of the design process are described:
• Customer needs analysis to understand the requirements of the socket
design based on the needs of the focus user population.
1
• Concept generation illustrating the variety of possible solutions
envisioned. In particular, the concept generation focused on fastener
technology that enables quick alteration of socket dimensions.
• Concept screening based on criteria developed during the customer needs
analysis to identify the best concepts for further development.
• Preliminary embodiment of selected fastener concepts, including
analytical models and testing of physical proof-of-concept models.
The thesis ends with a critical evaluation of the research and recommendations for future work.
2
Chapter 2: Background
PROSTHETIC SOCKETS
Limb amputation can be a life-altering event that requires special attention.

Individuals with limb amputations are often faced with issues including decreased
mobility, increased energy expenditure, negative social stigmas, added medical expenses,
or limited career choices. These amputations can be the result of trauma, disease, or
congenital defect (Limb Loss, 2009; Cummings & Kapp, 1992; Dillingham, Pezzin, &
MacKenzie, 2002). Efforts, therefore, over the last few decades have focused on
designing artificial limbs to fulfill the needs of 1.7 million people with limb loss in the
United States alone and the nearly thirty million anticipated by 2010 in developing
countries (Limb Loss, 2009; Guidelines, 2005). The most common type of amputation,
making up 23.95% percent of both upper and lower limb amputations in the United
States, is the below knee, or transtibial, amputation and is the focus of this research
(Dillingham et al., 2002).
Unlike developed countries where the primary reason for amputation is diabetes,
prosthetists in developing countries treat a larger percentage of cases where trauma is the
reason for amputation, 35.7% in developing countries compared to 17% in developed
(Dillingham et al., 2002; Ogeng’o et al., 2009, Table 1). These amputations are often the
result of a vehicle, work or military accident. As a result, a younger population, with an
average age of 29.2 years, is common in developing countries where the use of poor
quality or recycled components is often not capable of supplying the needs of the
amputee population (Ogeng’o et al., 2009). In comparison, most patients surveyed in the
United States were between the ages of 19-44 years rather than 10-19 years as in
developing countries (Dillingham et al., 2004; Ogeng’o et al., 2009). These patients
3
therefore, regardless of location, require the use of a mobility aid, referred to as a
prosthesis, due to limb loss commonly.
Cause Developed Countries Developing countries
Congenital Limb Use of thalidomide by mother Relatively unknown
Difference during pregnancy and other causes, genetic (20%)
unknown causes. (1%)
Disease Diabetes Mellitus or other Polio, malignancy of
peripheral vascular diseases bone or joint (44.3%)
and cancer. (82%)
Trauma Motor vehicle accident, Landmine accident,
workplace injury, war (17%) Hippo bite, workplace
injury, war, surgery
complications (35.7%)
Table 1: Causes of Amputation for Developed and Developing countries (Dillingham et

al., 2002; Ogeng’o, Obimbo, & King’ori, 2009)
1. Description of Prosthetic Limb
Though the quality can differ greatly, the solutions available to amputees around
the world are all based on a basic lower limb prosthetic design. For above knee lower
limb amputee, it is common to find, in addition to the socket and its suspension system, a
knee, shank (pylon), ankle, and foot component included in the prosthetic device. As a
transtibial amputee has an intact biological knee joint on the residual limb, the number of
required artificial limb components reduces to the socket, shank (pylon), and ankle/foot
components (Figure 1).
4
Figure 1: Basic Lower Limb Prosthetic Components (Photograph courtesy of The
University of Texas Health Science Center in San Antonio)
As a unit, the primary function of an artificial limb is to replace the motor

functions lost due to amputation. This functionality cannot be achieved without an
interface between the residual limb and the artificial limb. The socket component
provides this interface and is the focal point of this research.
2. Evolution of Prosthesis Design
The manufacturing technologies and materials available have largely limited the
quality of prosthetic interfaces designed throughout history. The simplest solution to limb
loss is the use of crutches or canes to help increase mobility. Early artificial limb designs
were simple suspension belts with a cushion to support the residual limb built into a
wooden frame. These were often referred to as ‘peg legs’ and are still common in low-
income regions today. Later, exoskeleton style sockets were developed using the same
skills required to manufacture armor (Figure 2). The resulting sockets provided basic
support but lacked the proper fit later determined to be necessary. (Gutfleisch, 2003)
5
Figure 2: Early Transtibial Prosthetic Limb Designs (Gutfleisch, 2003)
3. State of the Art
More contemporary designs use modern engineering materials and manufacturing

processes such as plastics or reinforced carbon fiber and Rapid Manufacturing
(Gutfleisch, 2003; Rogers et al., 2007; Trower, 2006). These modern socket designs also
utilize advancements made in understanding appropriate socket fit (Trower, 2006).
As the socket is the primary interface that distributes loads from the prosthesis to
the residual limb, the method used to distribute these loads is critical to patient comfort
and the quality of the socket fit. There are three primary schools of thought governing
proper weight distribution in a prosthetic socket. The primary transition from early socket
designs was the shift to total residual limb contact in the socket. The first of these socket
designs implementing this limb contact, introduced in 1959, is the Specific Weight
Bearing socket. This socket design is based on the thought that specific areas of the
residual limb are capable of supporting greater amounts of weight based on higher pain
tolerance levels. Particularly well known in this category is the Patella Tendon Bearing
6
(PTB) socket that uses the patella tendon as the primary weight bearing structure (Figure
3). Clinical Orthopaedics
80 Fergason and Smith and Related Research
PTB-SC Socket. Fig 3. Supracondylar socket.

The medial and lateral trim-
lines encompass the femoral
condyles giving coronal stabil-
ity and suspension. (Reprinted
with permission from Bowker
JH, Michael JW: Atlas of Limb
Prosthetics. Ed 2. St Louis,
Mosby Year Book 429-479,
1992.)
imal extensions of the socket that are con- tients find the cosmetic appearance of these
Figure
toured3:
upPatella
over the Tendon Bearing
distal femoral Socket
condyles, Design
sockets (Fergason,
unacceptable, J. &when
especially Smith,
they D. G.1999)
and anteriorly up over the patella and onto are sitting.
the quadriceps tendon. The proximal anterior
extension placessockets
These pressure on the associated
often require significant
TOTAL SURFACE manufacturing
BEARING skill by prosthetists who
soft tissue that will aid in prevention of hy-
perextension during stance, and by loading Total surface bearing is a different concept
manually modify
all around the patella atthe socket subtly
full extension, shape to thanprovide increased/decreased
total contact. The total contact tech- contact based on
unloads the tibia1 regions (Fig 4). niques that were introduced with the develop-
Although
locations these designsthrough
identified have defined bio-
gait-based mentobservations
of the patella tendon
on abearing socket
patient-by-patient basis for
mechanical benefits to the patient with an originally were targeted as a major change
amputated limb, the higher socket profile is from the open distal end socket designs. Now,
weight
revealedbearing.
most withAn kneealternative
flexion. Sometopa-the all
total
areascontact specific
of the limb weight
were to have bearing theory is the
some con-
Total Surface weight Bearing (TSB) theory. Manufactured in much the same way as a
PTB socket, this theory
quadriceps however assumes a more uniform distribution of weight bearing
bar
over the residual limb. The third major socket design theory to be discussed here is based
on fluid dynamics and lacks distinctive weight bearing structures such as those used in
Fig 4. Supracondylar and
PTB-SCSP socket. suprapatellar socket. Additional
pressure above the patella can
PTB and TSB sockets (Figure 4). aid in prevention of mild genu
recurvatum. (Reprinted with
permission from Bowker JH,
Michael JW: Atlas of Limb
Prosthetics. Ed 2. St Louis,
Mosby Year Book, 429-479,
Anterior 1992.)
7
Clinical Orthopaedics
82 Fergason and Smith and Related Research
tunately, the contours of the anteromedial

and anterolateral tibial flare regions (two ar-
eas that bear as much or more pressure than
the patellar tendon region) usually are much
less pronounced with the new pressure cast-
ing technique than when traditional hand
casting techniques are used. The resulting
sockets occasionally can be uncomfortable at
the distal tip of the tibia. The reason for the
increase in pain is thought to be that the tibia
is not being pushed back away from the
socket by generous indentations at the an-
teromedial and anterolateral tibial flare re-
gions of the socket. This problem can be
solved partially by pressure casting with the
knee in slight flexion as opposed to full ex-
Fig 5. Hydrostatic sockets are designed to ap- tension, or by restoring these tibial flare re-
ply pressure equally over the entire surface of
Figure 4:toPressure
the limb Distribution
all weightbearing tissue. Thereof
gions backSocket
is Hydrostatic
of-
into the (Fergason
socket design.&InSmith,
the au- 1999)
ten little anatomic definition in the socket. thors’ experience, patients in the first 12 to
(Reprinted with permission from Weber D, Agro 18 months after an amputation have had
M: Clinical Aspects of Lower Extremity Pros- more difficulty with this pressure casting
thetics.This
Ontario, Elgan Enterprises
Hydrostatic 1991.) fit is often
Socket achieved
technique by tibial
and the distal applying a uniform
pain, than pa- pressure to
tients who have more mature residual limbs.
the surface of the residual limb prior to casting to obtain the proper shape for the interior
other than slight relief at the anterior distal COMPUTER AIDED DESIGN
tibia, fibular head, and the tibial crest. The AND COMPUTER AIDED fit is the use of urethane or
of hydrostatic
the socket. Another method
socket is recommended to be used to obtain the hydrostatic
MANUFACTURING
used in combination with a silicone or simi-
lar material
silicone linerthat
liners for suspension
conformandtocomfortthe shape The of
use the residual
of computers limb
as an toforredistribute
option socket the surface
of the residual limb in the socket. manufacture rapidly is gaining acceptance by
The controversy surrounding the efficacy prosthetic practitioners. The limb shape is en-
pressure. (Fergason, & Smith, 1999). More
of the hydrostatic principle often centers
common is a blending of the PTB and TSB
tered into the computer either by taking a
around issues concerning the original biome- plaster mold of the limb and digitizing it or
style socket
chanical designs
design (Trower,
of a patella tendon 2006).
bearing using a surface scanning system. The pros-
socket. The patella tendon bearing was de- thetist then will modify the limb shape using
signedIn to accommodate the dynamic forces
order to manufacture a socket of the one
oneusing available softwareweight
of these programsdistribution
and methods
within a socket that occur during the gait cy- finally carve a positive model of the limb
cle. These forces continually are changing with a computer driven milling machine. This
fordirection
a particular patient,
and magnitude a surface
as the profileis of
patient ambu- onlythe residual
a tool limb
to help the is needed
prosthetist be more for customization.
lates. The hydrostatic socket makes no ac- efficient in the design and fabrication of the
Traditionally
commodation for thisthese
is obtained using
specific forces but a plaster
prostheticcasting method. do
socket; computers However,
not replace advancements in
assumes that pressure at one point will sim- the need for skill in evaluation, socket design,
ply be transferred
computer by the fluid
aided design (CAD) principle
haveto been individual
applied modification
to socket of anatomic regions, to improve the
manufacturing
other accommodating soft tissues. or limb alignment. Automated techniques do
Pressure casting is necessary to mold the allow for exact reproduction of a successful
models
residualof limbtheunder
internal socketexternal
more uniform profile socket
for the socket
design, design
and more desired
rapid design of newby the prosthetist
pressure, and was developed concurrently sockets or test sockets. This makes it possible
with theet
(Rogers silicone suspension
al., 2007; systems.2006).
Trower, to make new socketslimb
Unfor- High-resolution cost effectively
scanners to incor-
are available as well
as software for manipulation of the scans to produce the internal contour of the socket fit
desired. Additive Manufacturing (AM) technology has also been developed that
manufacture sockets from these digital models. One additive manufacturing technology
that has been used to fabricate prosthetic sockets is Selective Laser Sintering (SLS)
8
(Rogers et al., 2007). SLS, discussed in more detail later, is a layer based manufacturing
process that produces customized complex parts directly from a 3D computer model.
4. Pediatrics
For children, similar fitting and prosthetic design techniques are implemented.
The technology, however, must be modified to account for the more rapid neurologic
development, muscle strength increase, skeletal alignment, height increase, center of
gravity changes, and gait changes (Cummings, 2006). As a result of their normal growth
patterns, new prostheses are required more frequently for children. Children under five
years of age typically require a new prosthesis annually, biannually between 5 to 12
years, and then once every 3 or 4 years over 12 years of age (Cummings, 2006). In
addition to replacement of the prosthesis, prosthetists recommend frequent clinic visits,
as often as every three to five months, for follow up and adjustment of the prosthesis
(Cumming & Kapp, 1992).
GENERAL CASE NEEDS
In spite of the advancements made in understanding socket fit and improving

manufacturing technology, the issue of greatest concern to amputees continues to be lack
of proper fit and comfort in their socket (Dillingham et al., 2004; Legro, et al., 1999;
Pezzin et al., 2004; Trower, 2006). “Currently available components offer improved
function and superior symmetry of gait…The focus on the features of these components
sometimes has led, however, to neglect of the basic elements of prosthetic design-the fit
and the alignment,” (Trower, 2006). This lack of comfort and proper fit can often be
attributed to a change in the shape of the residual limb that cannot be compensated for by
existing prosthetic socket technology. This shape change is either the increase or decrease
9
in volume of the residual limb, in both the longitudinal and radial directions, caused by a
variety of factors.
1. Shape Change
Based on the age of the amputee, growth can account for significant volume
change in the residual limb. According to the National Health Statistics Report in 2008,
between the ages of two and twelve, girls will grow an average of 6.52 cm in height per
year while boys will grow 6.28 cm per year. By the age of nineteen, children have largely
stopped growing and may only increase by 0.1 cm per year. (McDowell, Fryar, Ogden, &
Flegal, 2006) The tibia, whose length change has the greatest effect on changing the
longitudinal fit of the prosthetic socket, can change on average 18.75 mm each year for
boys between the ages of 10 and 15 (Smith & Buschang, 2005).
In addition to vertical growth, weight changes can also contribute to changes in
the residual limb volume either positively or negatively. Due to the typically reduced
physical lifestyle of amputees, weight gain beyond the norm for aging is not uncommon.
Obesity occurred in 37.9% of transtibial, 48.0% of transfemoral and 64.2% of bilateral
amputee subjects studied. (Kurdibaylo, 1996) This weight gain causes an increase in the
volume of the residual limb that must fit inside the patient’s socket. For children, normal
weight gain must also be accounted for in the socket design. From the ages of 2 to 10, an
average increase of 3.65 kg/year for girls and 3.25 kg/year for boys is not uncommon
(McDowell et al., 2006).
Another period where volume changes are prevalent is during postsurgical
maturation. Studies have reported that the maturation process is often accelerated by
early ambulation. During the maturation period, the volume of the residual limb can
change as much as -8% to +2% depending on the method used to encourage shrinkage
10
(Golbranson et al., 1988). However, this is often a hindrance to early ambulation due to
the cost of manufacturing multiple sockets during the maturation period where the
residual limb volume is unstable. These postsurgical volume changes are often the result
of either edema, fluid retention that causes swelling, or muscle atrophy in the residual
limb (Golbranson et al., 1988). As a result, a stable volume measurement is difficult to
obtain in order to manufacture a single properly fitting socket, and multiple fittings or
volume adjustable sockets are needed.
Once the residual limb has reached maturity, volume fluctuations are not as
extreme but are still noticeable in adults. Short term volume changes due to movement of
fluid in the residual limb can occur. Removal of the socket after use can allow an increase
in volume between 2.4% and 10.9% (Zachariah, Saxena, Furgason, & Sanders, 2004). In
a comparison of suction and vacuum suspension systems, Board reports a decrease in
volume in the suction suspension of 6.5% following walking for 30 minutes while the
vacuum system increased in volume 3.7% (Board, Street, & Caspers, 2001).
2. Impact of Poor Fit
In the event a patient loses the proper fit of their residual limb in their prosthetic
socket due to one or a combination of the factors described above, there are several
possible negative consequences patients typically encounter. Limb volume can vary -11%
to 7% in a single day due to changing activity level or weight. However, volume changes
of only 3% to 5% can cause users to have difficulty putting on their prosthetic socket
(Fernie & Holiday, 1982). The most common problem amputees encounter with an
improperly fitting socket is the occurrence of pressure induced sores. Ulcers, irritations,
inclusion cysts, calluses, and verrucous hyperplasia account for 79.5% of skin problems
documented in a survey of 337 lower limb amputees (Dudek, Marks, & Marshall, 2006).
11
Similar to running shoes, the environment created by the residual limb inside the socket
provides the elements necessary to produce surface wounds such as blisters or ulcerations
(Backus, 2005). This environment provides the heat from the body and friction, pressure,
and moisture that couple with an improperly positioned socket to produce sores. If the
residual limb reduces in volume due to factors such as muscle atrophy or the socket is
incorrectly fitted, a phenomenon called “pistoning” can occur. In pistoning, the residual
limb volume reduces to such an extent that the limb moves relative to the socket during
gait causing a piston-like motion within the socket. This can cause blisters to form as well
as milking of the residual limb that draws fluid to the distal end causing, in the more
extreme cases, verrucous hyperplasia (Beil & Street, 2004; Backus, 2005). In addition to
forming sores on the residual limb, an improperly fitted socket can also cause the
remainder of the socket to fail to function as originally designed.
If the socket reduces in volume and the residual limb is allowed to move relative
to the socket, the alignment of the prosthesis can be altered, forcing the patient to adopt
an improper gait pattern that can cause strain in the remainder of the sound body (Backus,
2005). Poor alignment can also cause an increase in oxygen consumption and therefore
energy expenditure for the amputee (Schmalz, Blumentritt, & Jarasch, 2002).
Misalignment can increase the stresses at the knee as well as redistribute socket pressure
profiles (Blumentritt, Schmalz, Jarasch, & Schneider, 1999; Sanders, Bell, Okumura, &
Dralle, 1998). These possible injuries have motivated the design of a variety of volume
compensation options aiming to provide full functionality to the user.
3. Existing Solutions for Volume Compensation
Several options are currently available that attempt to compensate for volumetric
changes in the residual limbs of children and adults.
12
Children
For children, the simplest method used for volume compensation is the
addition/removal of liners or socks. The thickness of these inserts can be modified to
adjust for radial growth based on the specific needs of the patient. Another insert based
adjustment for radial growth is the use of ‘slip’ or ‘triple wall’ sockets. These sockets are
manufactured with a socket layer that can be removed when the socket becomes too tight.
In order to accommodate longitudinal growth, prosthetists use pads that are inserted into
the distal end of the socket during initial fitting and then replaced with thinner pads as the
patient grows. These pads provide cushioning in the socket as well as space for growth.
In addition to these, suspension systems can be designed with adjustability for growth.
(Cumming & Kapp, 1992)
Adults
As adults have stopped growing longitudinally, most volumetric change

experienced in the mature residual limb is due to radial changes from fluctuations in
weight. For more immediate location specific volume compensation, inserts are common.
These inserts are often gel bladders that in some cases are actively actuated to regulate
socket fit (Sanders & Cassisi, 2001; Greenwald, 2003). Another technique for
accommodating location specific volume change is the use of a ‘flexible’ socket wall. An
example of this is the use of compliant springs in the wall of a Selective Laser Sintered
prosthetic socket designed by Rogers, et al. at The University of Texas at Austin (2007).
As with children, socks and liners can be added or removed to accommodate a more
uniform volume change. The suspension system used by the patient can also contribute to
the volume compensation ability of the prosthesis. Research has shown that systems like
the Harmony Vacuum Assisted Suspension System (Harmony VASS) manufactured by
Otto Bock (www.ottobockus.com) can help reduce daily volumetric changes (Board et
13
al., 2004). This is due to the assistance provided by the vacuum being drawn on the
residual limb to maintain proper fluid flow in the residuum. Another method used to
accommodate shape changes, particularly post surgical, is the use of a socket design
consisting of five “plates” that are fitted together using supports and Velcro straps
(Sathishkumar et al., 2004). This sort of device can be adjusted for reductions in size due
to atrophy and swelling as well as increases in size due to body mass increase.
4. Shortfalls of Existing Technologies
Though some solutions are available, socket fit continues to be a point of interest
to amputees and prosthetists. The greatest problem with the existing socket designs is that
they are only capable of accommodating growth up to the maximum allowable volume
for which the socket was designed. Most of the readily available devices are primarily
designed for volume loss, such as inserts, rather than growth. These devices can increase
the complexity of the prosthetic by adding additional separate components that must be
maintained. Sockets are therefore oversized and then filled to accommodate future
growth. However as additional volume loss occurs, this means that insecure padding that
has been added compromises the strength of the interface. Most available volume
compensation devices are also only capable of adjusting for either radial or longitudinal
growth, but not both.
DEVELOPING COUNTRIES
Unfortunately, due to the lack of resources, technology available in developing

countries has not improved at the same rate as that in developed countries. From personal
observations at clinics in both Sierra Leone and Kenya, Africa, patients are often
provided with technology that has regressed to early prosthetic limb designs. For a
variety of reasons, patients are often found using only crutches or canes rather than actual
14
prosthetic limbs. When patients are able to obtain prosthetic limbs they are usually of the
simplest form, often using recycled components. The use of recycled components can
mean that an active youth may be using a component intended for an elderly patient and
is therefore unable to provide the necessary level of functionality based on the patient’s
activity level.
When components, particularly sockets, are manufactured, the quality of the fit is
dependent on the skill level and training of the technician. By 2010, the World Health
Organization (WHO) estimates that the number of prostheses demanded in developing
countries will reach thirty million (Guidelines, 2005). To fulfill this demand, more than
40,000 additional personnel are needed (Guidelines, 2005). However, the number of
prosthetic and orthotic facilities in several African countries is less than one per two to
four million inhabitants. This is significantly lower than the one prosthetist per 200,000 -
400,000 individuals common in developed countries. Those facilities that do exist
however, are often understaffed and lack the equipment and material necessary to
maintain production rates of facilities in developed countries. Those prostheses that are
manufactured tend to be of poor quality as a result of insufficient training, equipment,
and materials. (Disability, 1999)
To compound the issues of lack of adequately trained prosthetists and poor quality
prosthetic components, patients themselves often have difficulty simply obtaining
prostheses that are made available to them. Transportation often proves to be a hindrance
to patients in need of prostheses. Due to the lack of resources and low population
densities in rural areas, prosthetic services tend to be centralized to major cities and
capitals. This means that many amputees in rural areas are unable to obtain prosthetic
services due to the distances that must be traveled and the associated expenses. Finances
are also a large barrier to amputees in developing countries. Low cost or donated
15
prostheses are the primary source of prosthetic limbs in developing countries due to the
lack of funds. (Disability, 1999) This tends to eliminate the use of devices such as the
Otto Bock Harmony VASS that can cost upwards of $5000 to $50,000 dollars (Turner,
2009).
ADDITIVE MANUFACTURING
Due to the complex contours of the residual limb and the need for customization
of prosthetic sockets, Additive Manufacturing (AM) is particularly suited for this
application. Computer Aided Design and Computer Aided Manufacture (CAD/CAM) of
prosthetic sockets has been used for several decades, including uses in developing
countries (Smith & Burgess, 2001; Walsh, Lancaster, Faulkner & Rogers, 1989).
Traditionally, scans of the residual limb are obtained using 3D laser scanners and the
resulting surface contours are then modified by the prosthetist using CAD software.
These surface contours are sent to Computer Numerical Controlled (CNC) milling
machines that mill a positive mold of the socket to be manufactured. The final socket is
made from the mold by vacuum forming with plastic, such as polypropylene, or building
with reinforced carbon fiber (Bosker, 2008). Other methods mill the socket directly from
the socket material and skip the molding step (Walsh et al., 1989). The use of Additive
Manufacturing will further reduce the number of steps required for the prosthetist and,
more importantly, enable increased complexity and functionality in the design of the
socket.
1. Description of SLS
Selective Laser Sintering is an Additive Manufacturing technology that was first

developed by Carl Deckard at The University of Texas at Austin during the 1980’s
(Deckard, 1989). SLS is a layer-based technology that manufactures parts directly from a
16
3D solid model out of a variety of powdered raw materials. In using this technology, an
engineer first models the desired part using solid modeling software, and then sends the
model to the SLS machine in a special file format, the so-called STL file. This file
describes surfaces of the 3D part to be manufactured as a set of non-overlapping
triangular surfaces. The SLS software then essentially slices the part file into layers to be
built in the SLS machine. This research used the Vanguard HiQ/HS SLS machine
manufactured by 3D Systems (Rock Hill, SC). In one cycle of the process, a roller first
deposits a layer of raw material from a feed bin onto the preheated part bed. This material
can be either a plastic material such as DuraForm PA® (Nylon 12) or a metal-based
material such as LaserFormTM A6, both manufactured by 3D Systems. After powder
deposition, a CO2 laser scans the surface of the powder to melt the powder in the areas
contained in the current part layer. After scanning, the part bed lowers and the
appropriate feed bin raises a single layer thickness and the cycle restarts from the
opposite side of the machine. When all layers of the part have been sintered, the part bed
is allowed to cool and then the part is broken out of the unsintered powder that acts as a
support during the building process.
2. AM of Prosthetics
Building on the traditional use of CAD/CAM to produce a prosthetic socket,

additive manufacturing has been previously applied to prosthetic socket manufacturing.
Early SLS prosthetic sockets were manufactured at The University of Texas at Austin.
These sockets were designed to provide passive compliant regions for pressure relief in
the socket wall (Faustini et al., 2005; Faustini, Neptune & Crawford, 2006; Faustini et al.,
2006; Rogers et al., 2007). Relying on the design flexibility of SLS, the compliant
17
features evolved from simple thin wall designs to cantilevers to more complex spiral
spring designs.
Figure 5: Previous SLS Compliant Sockets from UT Austin (Faustini, Neptune &
Crawford, 2006; Rogers et al. 2007)
The Squirt Shape Prosthetic Socket developed at Northwestern University

(Evansville, IL) has also utilized AM (Rolock, 2007; Rovik & Childress, 1994; Herbert,
Simpson, Spence & Ion, 2005). The Squirt Shape process is similar to Fused Deposition
Modeling (FDM), in which a plastic filament is heated and extruded through a nozzle
moved by a three-axis table to build a part in circular layers. Similarly, Ng, Lee, and Goh
used FDM equipment (available from Stratasys, Inc.®, Eden Prairie, MN) to manufacture
a prosthetic socket (2002). The socket is built from essentially a single continuous bead
of melted plastic extruded along the desired contour generated using CAD software from
3D scans of the patient’s residual limb. This socket has reportedly passed the ISO 10328
standard.
18
3D printing, a technique where powder layers are sprayed with a binder by an
inkjet printer type head, has also been used to manufacture prosthetic sockets (Herbert et
al., 2005). However the strength and durability of these sockets has not been established.
PROBLEM STATEMENT
A new lower limb transtibial prosthetic socket design is therefore needed that can
satisfy the volume compensation requirements of the developing world’s pediatric
amputee population. In theory, this same design could easily be modified to aid amputees
all over the world. This thesis is a record of the initial stages in the design of a transtibial
prosthetic socket, to be manufactured using Selective Laser Sintering, for pediatric
patients in developing countries that accommodates long term volumetric changes in the
residual limb. The initial stages of the design of this prosthetic socket consist of the
design and analysis of volume compensation mechanisms for both radial and longitudinal
volumetric changes.
POTENTIAL IMPACT
A successfully designed volume-compensating socket has the potential to

positively impact amputee communities in developing countries. The greatest benefit to
the amputee community is the potential for increased longevity of socket usage each day
as well as the total life of the socket. This increased lifespan helps to reduce the required
number of additional fittings. This means that the number of visits patients must make to
the clinic can be reduced, allowing prosthetists to work with the patient’s culture by
adjusting to what they are capable of rather than forcing them into our framework of
more frequent visits and the associated costs (Pearlman et al., 2008). The use of CAD
software and SLS also provides a more precise model of the residual limb and therefore
improved socket fit that can reduce pressure related sores, resulting increased comfort
19
(Rogers et al., 2007). This volume compensation can also allow prosthetists to begin
fitting patients earlier after amputation allowing ambulation to aid the maturation process
(van Velzen, Nederhand, Emmelot & Ijerman, 2005).
20
 
Chapter 3: Proposed Solution Requirements
SOURCES FOR CUSTOMER NEEDS ANALYSIS
Designing a transtibial prosthetic socket manufactured using SLS for

accommodation of growth for pediatric amputees in developing countries requires certain
considerations to ensure that the customers’ needs are appropriately addressed. The
primary issue to be addressed in this design process is that the engineer cannot simply
assume they understand what a user needs (Pollak, 2008; Otto & Wood, 2000). They
must instead seek to discover the latent needs of the customer and make sure that their
design solution addresses these needs. The best way of doing this is to be able to simply
ask the patients what functions they would like in their prosthetic devices. Therefore, the
sources used in this thesis to complete a customer needs analysis were selected to provide
the best understanding of the customers’ needs in light of this issue. These sources
include a review of pertinent literature, personal experience at Prosthetic and Orthotic
clinics in Kenya and Sierra Leone, Africa, as well as interviews with a certified
prosthetist/orthotist. These sources were used to develop several design requirements for
this project, including manufacturing, biomedical and biomechanical, adjustability,
durability, and other user requirements.
Personal Experience
Personal experience with prosthetic limb design and manufacture, prior to the
current research, stems from participation in a senior capstone research program,
LeTrourneau Engineering Global Solutions (LEGS), now LeTourneau Empowering
Global Solutions, at LeTourneau University (www.legsresearch.org, Longview, Texas).
This program’s mission was to:
21
[D]esign, create, and test high-quality lower extremity artificial limbs
(prostheses) for patients across the developing world, focusing on above-knee
prostheses. These devices are designed to be inexpensive and maintenance free,
improving gait while still meeting the manufacturing, rehabilitation, and cultural
constraints of various international sites.
This program provided general knowledge of available prosthetic technology,

patient needs, culturally appropriate designs, patient fitting and rehabilitation methods,
and prosthetic manufacturing techniques during on-site clinic visits and laboratory
research. Two such clinic visits were completed; one in Sierra Leone, Africa at the New
Steps Clinic sponsored by Mercy Ships® and the second at the Bethany Crippled
Children’s Clinic in Kenya, Africa. During these visits, patients were fitted with
prosthetic limbs manufactured according to our low cost design. These transfemoral
prosthetic limbs can be manufactured using common handheld tools from readily
available material. Prior to these visits, potential prosthetic component designs were
developed and tested according to ISO Standards and compared against options available
in developed countries. The focus of the author’s research during involvement in this
program was on the prosthetic foot component and comparing it and other prosthetic
feet’s biomechanical characteristics with those of an intact foot (Gonzalez, 2007;
Vaughan, 2006).
SPECIFICATION SHEET
In developing the list of requirements for this project a Specification Sheet was
generated. This table lists each requirement, target value, and verification test to
determine whether the target value was reached at the completion of the project (Otto &
Wood, 2000; Table 2).
22
Design of a Volume Adapting Lower Limb Pediatric Prosthetic Socket
Specification Value D/W Test
Manufacturing
Manufactured using SLS Y/N D Check
Nylon 11 or 12 manuf.
Compatible Material Y/N D
For SLS
W370 x D320 x Volume of Build
Maximum Build Size H445 mm D
Cylinder
Post Processing Limited D Check
Biomedical/Biomechanical
Return patient to typical ambulation
Y/N D Gait analysis
levels
Distal Tibial contact Y/N D User feedback
PTB design Y/N W Check by prosthetist
Subject Age 3-10 years W Check
Adjustability
Radial Volume Change ± 15 % D Measure final design
Longitudinal Volume Change ± 18 % D Measure final design
Accommodate Local and Uniform Analyze space in final
Y/N W
Change design
Manual/mechanical Actuation Y/N D Check
Durability
Fatigue, wear, stress
Lifespan 3 years D
analysis
Water Absorption TBD W
Wear TBD W
UV Resistance TBD W
Force to Actuate TBD W
Static Load 45.7/2500 N W Static Load Test
Design Safety Factor 2 D Check
Other User Requirements
Compatible w/standard
Interface With Other Components Y/N D
adapters
Slim Profile - Pant Leg Clearance Y/N W User Survey
Cultural Applicability Y/N W User Survey
Table 2: Specification Sheet
23
MANUFACTURING REQUIREMENTS
Due to the complex contours of the residual limb and the need for customization
of prosthetic sockets, Additive Manufacturing (AM) is particularly suited for this
application. Additive manufacturing, specifically Selective Laser Sintering (SLS) has
been previously applied to prosthetic socket manufacturing at The University of Texas at
Austin (UT Austin). These sockets were designed to provide passive compliant regions
for pressure relief in the socket wall (Faustini et al., 2005; Faustini, Neptune & Crawford,
2006; Faustini et al., 2006; Rogers et al., 2007). The volume adjustable prosthetic socket
manufactured will, therefore, utilize this SLS technology. As this AM process utilizes
thermal processes, thermoset plastics such as Nylon 11 or 12 (DuraForm PA®
manufactured by 3D Systems, Rock Hill, SC) will be used. Metals, such as LaserFormTM
A6 are available but lack the elasticity needed in a prosthetic socket design. Using the 3D
Systems’ Vanguard HiQ/HS SLS machine available at UT Austin, parts as large as W370
x D320 x H445 mm can be manufactured using this SLS machine (3D Systems, 2001). If
an EOSINT P 730 machine were available, even larger parts in a build chamber of 700
mm x 380 mm x 580 mm would be possible (Electro, 2008). A final manufacturing
requirement is that the additional post-processing work be minimized. Some additional
post processing, such as bead blasting residual powder from part surfaces are required,
however, additional steps of assembly and finishing should be limited.
BIOMEDICAL AND BIOMECHANICAL REQUIREMENTS
In designing a prosthetic socket that plays such an important role in the health and
mobility of the user, certain biomedical and biomechanical requirements must be
considered. To develop this list of requirements, Gordon Bosker, Certified Prosthetist and
Orthotist at The University of Texas Health Science Center in San Antonio was consulted
to determine some of the more pertinent requirements (2008). According to Bosker, the
24
most important requirement is that the final socket must be capable of returning typical
ambulation levels safely. Also, the prosthetic socket must have contact with the distal
tibial end of the residual limb. This contact helps to ensure blood flow in the residuum
that contributes to a reduction in the amputee’s risk of developing verrucous hyperplasia
(Dudek et al., 2006; Fergason, & Smith, 1999; Bosker, 2008). For additional patient
comfort, the socket design should provide the patient with temperature control options if
possible to help reduce temperature and moisture related sores (Perry, Ledoux & Klute,
2005; Lachenbruch, 2005).
This research focuses on the Patellar Tendon Bearing socket design, since it is the
most frequently used design (Fergason & Smith, 1999). However, due to the design
flexibility of the SLS process, any volume compensation techniques developed using the
PTB style should be easily modifiable for any other lower limb prosthetic socket designs.
ADJUSTABILITY
As the intent of this socket is to compensate for volumetric changes in the residual
limb of pediatric amputees, there are several requirements that pertain to the level,
location, and method of adjustability of the prosthetic socket to be designed.
The target population for this research is children in developing countries between
the ages of two to ten years. As such, growth must be accounted for in two primary
forms: longitudinal and radial growth. The values used for this study were taken from the
National Health Statistics’ standard anthropometric data for adults and children in the
United States, surveyed during 2003-2006 (McDowell et al., 2006). Though the target
population is in developing countries, the use of this data provides a starting point for
best-case average growth patterns for children. Adjustments from this data can be made
on a case-by-case basis when specific patients are selected.
25
Radial changes are often the result of typical weight gain from maturation as well
as possible fluctuations post amputation when muscle atrophy or edema can change the
shape of the residual limb (Kurdibaylo, 1996; Golbranson et al., 1988). From the ages of
four to eight, normal growth patterns can account for increases in calf girth measurements
of as much as 4.6% per year for girls and 4.4% per year for boys (Meredith, 1950). From
the ages of 2 to 10, an average increase of 3.65 kg/year for girls and 3.25 kg/year for boys
is not uncommon (McDowell et al., 2006). Therefore a socket that can accommodate ±
15% total radial change will be the target for this design to accommodate normal growth
over a three year period as well as higher normal body mass measurements in amputees
and the potential for volume loss due to atrophy (Kurdibaylo, 1996).
Longitudinal changes in the specific location of amputation can help to provide
the best measure for how much vertical adjustability is needed in the prosthetic
introduced into that location. For this socket design therefore, the length change of the
tibia is of greatest concern. The tibia can lengthen as much as 22.02 mm in a year for
boys and 19.81 mm for girls between the ages of 10 and 17 (Smith, 2005). This
corresponds to a target of 18% change allowance in longitudinal length of the prosthetic
socket to be designed.
The particular type of volume change accommodation required determines the
specific locations of the volume change. For radial change, it is hard to determine which
of two ruling schools of thought prevails: local or uniform volumetric changes. In most
cases, it seems the choice of method is made on a patient-specific basis (Bosker, 2008).
In this study therefore, both uniformly and locally distributed volume changes will be
accommodated. This will allow adjustability over the length of the residual limb with
additional specific adjustment over sensitive regions identified by the prosthetist for the
specific patient being fitted. Longitudinal changes should be accommodated such that the
26
length of the socket itself is changed. Changing the length exterior to the socket, such as
by shortening the pylon, is only a temporary fix. A socket with a fixed length means that
the growing residual limb must continue to fit within a socket that is in contact with a
smaller percentage of the limb than originally designed. In accommodating volumetric
changes in this way, boney alignment changes from typical childhood maturation as well
as weight fluctuations can be accommodated in the prosthetic socket design (Cummings
& Kapp, 1992).
ACTUATION
One of the distinct differences between the socket to be designed and those
previously completed at UT Austin and other AM sockets is the use of actuation in
volume compensation. As the addition of actuation will extend the adjustability of the
socket volume beyond passive compliance, this socket design will incorporate actuation
mechanisms. The method of actuation used must meet certain requirements based on the
needs of the customer. First, as the goal of this prosthetic socket is to make it applicable
for use in developing countries, a manually powered actuation device is necessary due to
the lack of readily available portable energy sources. Also, the actuation mechanism must
be usable by the pediatric population. A survey of mechanisms regularly encountered by
children provides a variety of analogies to be considered in the design of the actuation
mechanism. These include mechanisms such as push buttons, switches, dials, latches or
ratchets. Illustrations of such devices are provided in Chapter 4 Table 3. When
considering designs intended to restrict child usage, mechanisms tend to incorporate
multiple steps that are often in the opposite direction of the intended motion when the
mechanism is released. Mechanisms specifically designed for children, therefore, tend to
be large in size and require one-step actuation. In some cases, feedback for when the
27
mechanism is successfully actuated is provided by means of sounds or exaggerated
motion. The actuation mechanism designed for pediatric patients should, therefore, utilize
these types of appropriate mechanisms.
ROBUSTNESS
In designing a prosthetic socket for use in developing countries, special

consideration must be made for ensuring the robustness of the design given the working
environment of the device. The target lifespan for this device is a minimum of three years
where typical devices last only one to two years for the target population of children from
three to ten years of age. Literature has reported that children under five years of age
typically require a new prosthesis annually, biannually between 5 to 12 years, and then
once every 3 or 4 years over 12 years of age (Cummings, 2006). Increasing the lifespan
of the socket has the potential to help lengthen the amount of time between fittings and
therefore the monetary, material, and capital costs of fittings during the time where the
greatest number of sockets is typically needed. Due to the fact that the user will most
likely be using their prosthesis in a harsher environment than their developed country
counterparts, the device must withstand prolonged exposure to water, sunlight and wear.
An in-depth study of available materials for this prosthetic socket application is beyond
the scope of this thesis for now. Therefore, for this study, the Arkema Nylon 11 material
previously implemented will be used.
In addition, the device must endure extreme loading conditions so that the user is
not injured in the event of an emergency. A survey of peak ground reaction forces (GRF)
produced by elementary school children completing a variety of jumps found that the
greatest GRF was attained while completing a maximal effort plyometric jump (a two
footed vertical jump immediately preceded by a drop jump off of a raised platform). At
28
minimum therefore, the socket, including any actuation mechanisms, should withstand a
plyometric jump equal to five times the subject’s body weight. (McKay et al., 2005)
Ultimately, the final prosthetic socket should be tested in accordance with the
International Organization for Standardization standard 10328 for structural testing of
lower-limb prostheses. This international standard accounts for both static and dynamic
loading conditions (International, 2006). Other prosthetic socket designs manufactured by
FDM have passed these rigorous testing standards, which suggests that a socket design
manufactured using SLS that meets these standards should be achievable due to the
greater material strengths available using SLS (Ng et al., 2002).
Figure 6: Comparison of Additive Manufacturing Processes to Tensile Strength (Kim &

Oh, 2008)
As the focus of this thesis is limited to the design of volume compensation

mechanisms rather than prototyping a final socket design, full ISO compliance testing is
beyond the scope of the current research.
29
ADDITIONAL USER REQUIREMENTS
In addition to manufacturing, biomedical and biomechanical, adjustability, and

durability requirements, there are several requirements pertaining to patient ease of use
that must be addressed.
First, a simple interface with the remainder of the prosthetic must be achieved.
This includes attachment to a suspension system as well as to a pylon adapter. There are
several methods used for suspension of the prosthetic socket. The most popular include
pin, belt, suction, and vacuum assisted suspension. Pin suspension is achieved when a pin
fixed to the distal end of a tightly fitting liner is inserted into the socket and locked into
the distal end of the socket. Another method of suspension is to use suction to grip the
residual limb. This is often aided by the use of vacuum, known as a vacuum assisted
suspension system (VASS), to maintain the proper suction level. The simplest method for
suspension of the prosthetic limb is the use of a belt that fits around the socket and
secures it to the upper portion of the residual limb or the waist. This suspension method
therefore will be assumed for this research. (Bosker, 2008; Wirta, Golbranson, Mason &
Calvo, 1990)
The connection with the components located distal to the socket is traditionally
achieved using a pyramid style adapter (Figure 7).
Figure 7: Pyramid Style Adapter Components (Ossur, 2009)
30
The designed prosthetic socket, therefore, must mate with a universal adapter or have an
integrated pylon adapter. Further reduction in the number of components could be
achieved through the inclusion of the pylon and adapter into the socket design as long as
the entire unit fits within the build volume.
A strong correlation between amputee body image, self-esteem, anxiety and
depression has been demonstrated in the literature and motivates the design of prosthetic
components that will help to improve body image (Breakey, 1997). This can be partially
accomplished by designing components that are culturally appropriate for the patient.
From personal experience and literature, it has been shown that the aesthetics and
available functions of the prosthetic components can impact the acceptance of the
amputee back into the community (Meanley, 1995). For example, in developed countries
it is not unusual for an amputee to attempt to hide prosthetic components completely. In
order for the amputee to accomplish this, the socket designed must remain inconspicuous
under a pant leg or skirt without harming the garment. This means that sharp edges or
joints must be removed or covered and a slim profile obtained.
31
Chapter 4: Design Solution Concept Generation
CONCEPT GENERATION METHODS
Concepts for this socket design were based on the aforementioned requirements
and were generated using modified concept generation techniques such as Design by
Analogy, Word Generation, and 6-3-5 (Otto & Wood, 2000). These techniques were used
to generate concepts for the functions required of the socket design. Identification of
these functions was accomplished throughout the process of establishing the requirements
of the design solution during the initial customer needs analysis (Chapter 3). The socket
functional requirements considered during the concept generation process were:
accommodation of both radial and longitudinal volumetric changes in the residual limb,
ability to interface with a socket suspension system and other prosthetic components, user
safety and aesthetics, and methods to combine mechanisms designed for each function
above. By focusing the concept generation process on each of these socket functions, a
variety of detailed potential design solutions were generated using the design by analogy,
word generation, and concept sketching techniques.
1. Design By Analogy
In Design by Analogy, design solutions for products that perform analogous

functions are used to motivate generation of concepts for the current socket design
problem (Otto & Wood, 2000). Analogies were drawn from existing prosthetic
components, toys, tools, and other simple mechanical devices that are modified to create
a change in volume. As the device to be designed is itself a prosthetic component, a
review of other prosthetic components was completed to provide analogies upon which to
draw. These include components such as suspension belts and pyramid pylon adapters
(Figure 7).
32
Examples of analogies identified from commercially available toys were “Chinese
Finger Traps” and Rollerblades (Table 3). The Rollerblade ratchet strap was of particular
interest due to its incremental nature and ability to easily select a desired volume.
Commercially available tools also provided valuable analogies in the form of a
pipe clamp and forceps. These tools are regularly used for applying pressure to an object
to provide a secure hold but the applied pressure is variable and not permanent which is
also desired in a socket design. Pipe Clamps in particular were considered due to their
unique ability to expand or contract around a cylindrically shaped object (Figure 8).
Figure 8: Pipe Clamp Example (www.McMaster.com)
33
Child Resistant Description
Sliding Door Cabinet Lock by Kidco, Inc.

• Requires two motions to release: Slid along rail and
unhook from handle.
Door Knob Lock by Kidco, Inc.

• Adds application of force to secure lock to doorknob
before allowing rotation.
• Spins freely when not engaged
Adjustable Latch by Kidco, inc.

• Requires pinching of release to unhook latch
• Motion is in opposite direction of desired travel
Child Resistant Pill Bottle Cap

• Requires two motions to release: Push and Turn
• Increased resistance also makes these harder for children
to open.
• Other designs require turning cap to align to marker and
then flipping open.
Child Friendly Description
Hasbro Playskool's Sesame Street Busy Poppin' Pals

• Incorporates multiple single action switches
• Twist
• Switch
• Slide
• Press
• Large surface area, bright colors, and motion
Table 3: Analogies Considered for Actuation Mechanisms Pertaining to Children
34
Rollerblade Buckle
• Ratchet style mechanism
• Lift buckle to release and slide to change size
Childs Clothing
• Buttons
• Zippers
• Velcro
Walmart Razor A Kick Scooter

• Foot break requires applied force on lever
• Collapsing mechanism requires turning lever to release
pin
• Handles collapse by pulling out and folding
Century Novelty Finger Trap

• Push/Pull actuation
• Minor diameter is a function of length
Table 3: Analogies Considered for Actuation Mechanisms Pertaining to Children (cont.)
Fasteners such as screws and push button releases, as seen on telescoping poles,
were also inspirational for the design of connections between socket functions. Other
mechanical devices identified as analogies to draw from were liner and torsion springs
whose minor diameter changes as they are stretched or twisted. A final analogy identified
35
was a camera aperture that provides an illustration of yet another method for changing the
shape of a device to accommodate additional volume. From these existing technologies,
analogies were drawn from the basic functions performed and applied to the design
problem at hand.
2. Word Generation
An additional method used to generate possible solutions was through the

generation of words to inspire design ideas. For this method, five participants, including
the author, were given ten minutes to generate as many words as possible based on a seed
phrase. All participants were mechanical engineering graduate students at The University
of Texas at Austin spanning both biomechanical and design backgrounds. In order to
encourage generation of unusual concepts, only two of the participants were informed
prior to word generation how the final results would be used. Each participant generated
at least twenty words for the seed phrase: Change Shape. Upon completion, participants
were given a more thorough description of the socket design problem for which they
would generate concepts in the next step of the concept generation process.
36
Concept Word Generation on Seed Phrase: Change Shape
Participant 1 – Inflating, Folding, Interlocking, Clinching, Cinching, Collapsing,
Twisting, Rotate, Depress, Curl, Sag, Hinge, Spin, Unfurl, Wrap, Melt, Solidify,
Bend, Aperture
Participant 2 – Bending, Folding, Telescoping, Expanding, Shrinking, Origami,
Adjustable modules, Sliding, Reorganizing, Filling with air, Creating a vacuum,
Linkages, Layering, Rotate, Elastic, Phase change, Transformers (robots),
Umbrella, Bi-state materials/geometries, Springs, Freezing/Melting,
Transport/Fluid Flow, Hinges, Stuffing, Crinkling, Flexibility, Nesting
Participant 3 – Bending, Break it, Stretch, Push on it, Fold, Snap together, Attach to
something heavy, Apply pressure, Twist, Heat/Chill it, Pull Apart, Tear, Melt, Sand
it, Pinch, Submerge, Fill, Remove air, Throw it against a wall, Transformers, Twirl,
Twist, Ribbon, Crimp, Straighten, Brake, Solder, Glue, Drill, Cut, Burn,
Centrifuge/Spin, Attach weights, Apply point force, Scratch, Hammer stuff into it,
Chemical Stuff, Strings
Participant 4 – Stretch, Twist, Bend, Tear, Inflate, Charge, Press, Roll, Draw (as in
metal working), Squeeze, Fold, Compress, Pump up, Fill, Form, Deflect,
Melt/Freeze, Draw vacuum, Cut/Add material Expand Shim, Screw
Participant 5 – Expansion, Contraction, Add/Subtract material, Materials that
stretch/contract, Fold, Unfold, Balloon, Shift, Bend, Insert additional material,
Mold, Morph, Bending, Grow, Break/Chip away, Compress w/weight or pressure,
Pulling, Stretching
Table 4: Concept Word Generation Results
3. Concept Sketching
Using the words generated from the method described above, a sketching based
brainstorming process inspired by Otto and Wood’s 6-3-5 method was completed. 6-3-5
is a graphical brainstorming technique used to generate a variety of design concepts using
sketches rather than words for communication. For this activity, the same five
participants used the words generated previously as the starting point for sketches of
possible design solutions. The participants were not given a particular time frame to work
in but asked to work for as long as they were continuing to generate concepts. After
37
approximately thirty minutes of silent sketching, all sketches were collected and reviewed
by the group.
GENERATED CONCEPTS
After the completion of the concept generation methods described above, the
generated concepts were grouped according to the required socket function(s) they
fulfilled. As a result, a variety of concepts for radial and longitudinal volumetric change,
interfacing with a socket suspension system and other prosthetic components, user safety
and aesthetics, and methods to combine mechanisms designed for each function above
were obtained.
1. Volume Adjustment
Volume adjustment, as discussed previously (Chapter 2), consists of both radial

and longitudinal volumetric changes. Of the volume compensation concepts generated,
fourteen were for radial variation and seven were height change concepts. The more
promising of these concepts are described in more detail here.
Radial Change
During generation of concepts to accommodate radial volume changes, words

such as expand, inflate, stretch, twist, and insert were used to generate design solution
concepts. Several of the more promising concepts are described here.
First in the radial change set of concepts is the camera aperture analogy concept.
A camera aperture’s function is to reduce the amount of light that passes through the lens.
This is accomplished by sliding a series of overlapping sheets until the diameter of the
circular opening reaches the desired size. This motion can be similarly used in the
reduction of the approximately circular diameter of the prosthetic socket. To accomplish
this, the primary socket walls would be sectioned into longitudinal plates that would slide
38
around each other until the available volume was reduced by the desired amount. Figure
9 illustrates both the expanded and collapsed top views of the aperture radial volume
compensation concept.
Figure 9: Aperture Design Concept (Top View)
Another radial volume compensation concept generated that relies on the motion
of longitudinal plates is the Internal Sliding Plate concept. Unlike the Aperture concept,
the Sliding Plate concept, illustrated in Figure 10, more closely maintains the internal
socket shape while expanding without rotating with respect to the residuum. To
accomplish this, sliders are built into the socket wall and allow for expansion of the
socket along manufacturer selected vertical joints.
Figure 10: Internal Sliding Plates Design Concept (Top View)
39
Another analogy-based concept is the Pipe Clamp radial displacement method.
This idea is based on a pipe clamp, as shown in Figure 8, whose available volume is
changed by adjusting the size of the gap between the edges of the plate. Similarly, the
socket wall can be modeled as a single plate that wraps around the residual limb.
Contracting or expanding the space along a gap in the socket wall then achieves volume
compensation. One possible gap design is shown in Figure 11.
Figure 11: Possible Pipe Clap Design Concept
In the event that the gap made by the Pipe Clamp concept is greater than what is
acceptable to the user, the Removable Wall Section concept is an alternative arrangement
for the design of the gap. This concept helps to maintain stability and residual limb
coverage by adding/removing sections of the socket wall in locations determined by the
prosthetist during initial fittings. To help maintain the structure of the socket, joints, such
as a sliding dovetail joint, can be used to align the removable wall section. The size of the
sections can also be modified to account for a variety of radial size changes.
40
Figure 12: Removable Wall Design Concept
Similar to "slip" or "triple-wall" sockets, the Solid Socket Insert concept uses a
single profile of the interior of the socket that is then scaled to a variety of sizes
(Cummings & Kapp, 1992). These scaled internal contours are then used to manufacture
socket inserts that can be added or removed as the volume of the residual limb changes.
These inserts would be manufactured using the same method as an oversized base socket
in which they fit. This base socket provides the primary structural support and interface
with the remainder of the prosthetic limb.
In addition to those mentioned above, several other radial displacement concepts
worthy of mention were generated. These include an analogy to an accordion where
sections of the socket wall are crimped, allowing the wall to be stretched or contracted to
accommodate socket diameter changes. Additional plate style socket concepts include the
Hinged Sections and Pressure Plate concepts. In the Hinged Sections concept, the
diameter of the socket is changed by rotating sections of the socket wall about the hinge
point at the distal end of the socket (this concept is partially illustrated in the description
of this fastener in Figure 19). The Pressure Plate concept consists of a variable number of
41
separate surfaces that can be independently adjusted against the residuum to achieve the
desired socket fit. These plates fit within a base socket and are actuated by mechanisms
anchored to the wall of the base socket. As most of the plate style socket concepts require
some sort of mechanism to maintain their deformed shape, the Spreader Socket concept
addresses this issue. This concept incorporates a basic plate style socket concept with
adjustable bands to maintain the desired shape of the socket. On these bands are angled
protrusions that fit between the plates in the socket wall. As the band is moved along the
length of the socket the protrusions force the socket to expand, causing the diameter of
the socket to change. Inflation of chambers in the wall of the prosthetic socket could also
be used as a volume compensation method. The final design concept to be discussed is
the Linear or Torsion Spring concept. This concept is based on the diameter changes
obtained by deforming springs by stretching or twisting. This is also very similar to the
behavior of a Chinese Finger Trap.
Longitudinal Change
As with radial changes, concepts were generated using the methods described
previously for accommodation of vertical growth. Of those generated, the leading
concepts are described here.
The first longitudinal adjustment concept is the Plunger concept. This concept
accommodates vertical growth inside the socket by actuating a distally located cap within
the socket. This cap is designed to the contour of the distal end of the residual limb on
one side and on the other to interface with an actuation mechanism such as the gearing
system shown in Figure 13. To accommodate for the added space for both the growth and
the actuation mechanism, an oversized external socket structure is required.
42
Figure 13: Plunger Longitudinal Height Adjustment Concept
Similar to the Removable Wall Sections concept that is used to accommodate

radial change, the Interlocking Rings concept provides incremental changes in the length
of the prosthetic socket. In this concept, additional length is added to the socket by way
of rings that lock into one another as well as the socket. These rings can be added at any
desired point along the length of the prosthetic socket. Figure 14 shows a possible
arrangement of this concept applied at the proximal end of the prosthetic socket.
Figure 14: Interlocking Rings Design Concept
43
The Threaded Wall longitudinal adjustment concept uses threads to create a
modular socket design. Figure 15 shows this concept being used to lengthen the socket on
the distal end at the connection to the pylon, this concept can also be applied to a design
similar to the interlocking rings concept. In this way each of the added rings connects to
the socket by threading it onto the main socket.
Figure 15: Threaded Wall Design Concept
As has also been previously done with pediatric prosthetic sockets (Cummings &
Kapp, 1992), another method to accommodate vertical growth is the inclusion of solid
inserts inside the distal end of the prosthetic socket. The remaining concepts generated
for height adjustment pertain to the adjustment of the length of the pylon rather than the
length of the socket itself. These include a Push Button style extender of the mounting of
the pylon to the prosthetic socket. To change height in this concept the button is
depressed until the interior section can be moved. The reshaped socket is secured by
releasing the buttons back into the desired opening in the socket wall. This same method
of adjustment can also be accomplished using a simpler design consisting of a separate
pin to fit through the desired hole at the required height setting.
44
2. Pylon Attachment
In addition to volume compensation, the socket design must also incorporate an

interface with the remainder of the prosthetic socket. This includes both interfacing with
the suspension system as well as the pylon. As socket attachment can be achieved
without significant modification of the prosthetic socket using commercially available
methods such as suspension sleeves or belts, the focus of concept generation was
therefore on the development of a pylon attachment mechanism.
A simplified method for attaching the pylon to the socket is achieved by rigidly
securing the pylon to the socket. This is accomplished by manufacturing a rigid opening
for the pylon to be inserted into and then secured using glue or set screws (Figure 16).
This method relies greatly on the ability to align the prosthetic prior to manufacturing as
adjustability is lost.
Figure 16: Set Screw with Through Holes Pylon Adjustment
Building on the work already completed at The University of Texas at Austin, the
use of a reinforced SLS structure for connection of a pyramid adapter is a possible
method for interfacing with the distally located prosthetic components to provide
45
flange nuts so that a wrench is not needed to prevent the nuts from turning during
tightening (Figure 4). A finite element (FE) model of a socket was used to model the
strength of the socket and adapter. Sockets have been tested to destruction in order to
validate the model and to verify that the socket/pylon adapter interface was suitable strong
(Faustini et al. 2001).
Sockets incorporating internal circular attachment plates (grace plate) are also popular.
This is a simple design to incorporate into an SLS socket. The plate fits snugly in the distal
end of the socket positioned to match holes in the distal end. This design can also be used
with an adapter for pin suspension (Figure 5).
This long-term evaluation is ongoing with the goal of having ten amputees wear a SLS
socket for a year. The evaluation criterion for the long-term durability study is simple. Either
the socket fails or it does not.
Stage 4: Novel construction for selective control of flexibility

alignment capabilities. Illustrated in Figure 17 are existing embodiments of mounting
Stage 1 used triangular cantilever beams for controlling flexibility while Stage 2 and Stage 3
use variable wall thickness for control of flexibility. A more sophisticated design has been
incorporated for better control of flexibility (Faustini et al. 2005).
plates for a pyramid adapter, such as the one illustrated in Figure 7. The mounting plate
Four spiral slots in the socket wall define a compliant region. The centre of each spiral area
is backed by a diaphragm spring. The flexibility of the spiral region is varied by changing the
thickness of the diaphragm spring (Figure 6).
shown utilizes the manufacturing abilities of SLS to include specially designed slots to
Stage 4 is in progress. Ten trans-tibial amputees will receive a conventional socket as well as
two SLS sockets each having different degrees of flexibility. Each socket will be worn for a
month before undergoing a complete biomechanical analysis including Vicon optical motion
(Vicon Peak. 9 Spectrum Pointe Drive, Lake Forest, CA 92630, USA) capture and Tekscan
secure the nut in the socket mounting plate such that an additional tool is not needed.
in-socket pressure testing (Tekscan Inc. 307 West First Street. South Boston, MA 02127-
1309, USA).
96 B. Rogers et al.
Figure 4. European four holed adapter. Figure 5. Pylon adapter using grace plate.
Figure 17: Existing Integrated Mounting Plate Designs (Rogers et al., 2007)
Building on this idea of an integrated mounting plate for a pylon adapter is the
concept of incorporating the adapter into the socket itself. In this case, the pyramid
adapter would be manufactured with SLS but perform the same alignment functions.
Further combination of components is accomplished by inclusion of not only the
pyramid adapter but also the pylon. This produces what has been called a Monolimb
Figure 6. Cross-section of compliant region.
design. The Jockey Club Rehabilitation Engineering Centre at The Hong Kong
Results
Polytechnic University developed
Stage 1 involvedone such
one socket design
for a trans-tibial (Figure
amputee. The socket18). Theirsocket
was a double-wall monolimb is
with cantilever compliant regions over the distal tibia and fibula head. The subject’s existing
foot was used in conjunction with the SLS socket. The prosthesis was aligned by moving
manufactured by molding polypropylene homopolymer. eccentric cylinders in the pylon adapter. An instrumented gait analysis showed little difference
46
6 2 2 1 4 ysis (Lee et al., 2004) that the loading condition II
7 2 3 4 1 caused much more deformation and higher stresses to
8 2 4 3 2 monolimbs than loading condition I because of the
9 3 1 1 1 longer moment arm. Facture failure of monolimb was
10 3 2 2 2
11 3 3 3 3
unlikely under the loading condition specified in
12 3 4 4 4 ISO10328, due to the high ductility of thermoplastic
13 4 1 4 2 material. However, permanent deformation could occur
14 4 2 3 1 in some monolimb designs which is undesirable as it per-
15 4 3 2 4 manently changes the alignment of prosthetic foot rela-
16 4 4 1 3
tive to the socket. Based on the above information, force
specified in ISO10328 simulating heel off at normal
walking load was used to load the prosthesis in the FE
model during the design stage. The selected test load le-
vel was A80 (1085 N). There are three test load levels
specified in ISO10328 which accounts for the different
amputee body weights. A80 is for amputees whose
weights are between 60 kg and 80 kg. Geometric
nonlinearity resulted from the large deformation was
considered in the model. Peak von Mises stress, dis-
placement of the top load application point, dorsiflexion
and inversion angles defined as the angle changes be-
tween the top and bottom aluminium blocks in sagittal
and frontal planes respectively were predicted in the
FE model. Through testing different designs, the aim
was to design a prosthesis providing high flexibility
but without permanent deformation under normal
walking.
2.2. Taguchi method and design optimization
Four design factors namely, the thickness (T) of the

Fig. 1. Four design factors considered in the design of monolimbs.
thermoplastic material, depth of posterior seam line
Figure 18: Monolimb Socket Design Example (Lee & Zang,
(S), anteroposterior (AP) 2005)
and medial–lateral (ML)
defined among the foot bolt, distal end of the shank and dimensions of the shank (Fig. 1) were selected for eval-
foot block so that their surfaces were not allowed to uation. Each factor was assigned with four levels (Table
3. Fasteners
penetrate each other when loading was added. The 1). The thickness of the polypropylene material was in
model in its entirety, as shown in Fig. 3b, was exported the range of 4–7 mm. The AP/ML dimensions and depth
to ABAQUS version 6.4 (Hibbitt, Karlsson and Soren- of the seam were in the range of 25–55 mm and
sen, Inc., Eight
Pawtucket,methods
RI, USA).to A combine
FE mesh of mechanisms
3D designedconcerning
0–15 mm respectively for each function
the bulkiness above were
and the
tetrahedral elements was built using ABAQUS auto- structural integrity of the monolimb. To identify the rel-
meshing techniques. Tetrahedral element was chosen ative significance of the design factors using full factorial
developed. Includedirregular
because of geometrically in this set ofofconcepts
structures the is thea more
approach, promising
total number fastener
of total number methods titled
256 analyses
monolimb. The number of elements ranged from (44) are required. In this study, a statistics-based-Tagu-
the Hinge,
27,337 to 39,029Ratchet,
depending onand the Thread Fasteners
shape of the
The Young!s modulus and Poisson!s ratio of the
shank. concepts.
chi method was used to reduce the number of analyses.
Sixteen simulations were required. The configurations of
monolimb made of polypropylene homopolymer were the monolimbs were shown in an orthogonal array L16
1500 MPa Used
and 0.3 in the Hinged
respectively (Margolis,Sections
1985). Foot radial change
(Phadke, 1989) inconcept,
Table 2. The themechanical
Hinge responses
Fastener is one
concept that can be used to connect different adjustment mechanism concepts. Figure 19
illustrates one possible embodiment of the Hinge Fastener, where separate plates rotate
with respect to a common hinge point.
Figure 19: Hinge Fastener Design Concept
47
Joining portions of an adjustable socket design can be achieved due to the
potential for SLS to manufacture functional Threaded Fasteners without additional
machining steps. As previously shown, Threaded Fasteners can be used to adjust the
longitudinal length of the prosthetic socket (Figure 15). In addition, the Screw Expander
concept shown in Figure 20 demonstrates how a threaded fastener can be used to
maintain the distance between socket sections.
Figure 20: Screw Expander Design Concept
Akin to metal straps that maintain the shape of wooden wine barrels, the
Horizontal Bands concept is another method for connecting sections of a modular style
prosthetic socket (Figure 21). These straps can be permanently fixed at select vertical
heights along the socket wall and then tightened radially into place using other
connection methods such as the ratchet or threaded fastener concepts. Alternatively, the
diameter of the bands can be fixed and then slid along the length of the socket to tighten
or loosen around the changing residual limb shape. Incorporating guiding slots in the
back of the band and corresponding rails on the socket pieces can further improve
alignment of the modular sections.
48
Figure 21: Horizontal Bands Design Concept
Analogous to rollerblade latches, the Ratchet Fastener concept uses angled

threads to secure a joint in the socket design (Figure 22). Due to the nature of the
concept, the amount of incremental change is set by the strength of the material and the
design of the teeth. In general, increasing the number of teeth increases the adjustability
of the connection. Adding additional interlocking teeth can help increase the joint
strength. Removal of the Fastener can be aided by the addition of a release edge that
allows the required force to be applied to disengage the latched teeth.
Figure 22: Ratchet Design Concept (Top View)
The final fastener concept generated is the Locking Fastener. As demonstrated in

the Interlocking Rings longitudinal adjustment concept, the Locking Fastener is another
49
Fastener concept for the adjustable socket design (Figure 14). These locking pins are
manufactured directly into the socket wall and utilize friction to secure the Fastener.
4. Safety
Though patient safety may not greatly impact the functionality of the final
adjustable socket design, addressing patient safety during the concept generation phase is
still important as it is a key patient need. Producing a prosthetic that accommodates
volumetric changes but has a tendency to pinch or cause other types of harm is in direct
opposition to the need for a comfortable socket that is driving this research.
As illustrated in Figure 22 above, one possible means of increasing user safety is
by adding guards over the mating surfaces. This will help to protect clothing and skin
from potentially being caught in the volume or radial adjustment mechanisms. This can
also be accomplished by adding a liner or cover.
Since in most cases it seems the choice between local or uniform volumetric
change methods is made on a patient-specific basis, both uniformly and locally
distributed volume changes will be accommodated in this study (Bosker, 2008). This
allows adjustability over the length of the residual limb with additional specific
adjustment over sensitive regions identified by the prosthetist for the specific patient
being fitted. Potential designs for these compliant regions will likely build on designs
already generated at UT Austin. These include the spiral spring passively actuated
compliant region (Figure 23.a) and the thin walled compliant region (Figure 23.b).
50
Figure 5. Pylon adapter using grace plate.
94 B. Rogers et al.
Figure 6. Cross-section of compliant region. Figure 3. Components of SLS prosthetic limb.

Figure 23: Existing Actuated (17.a) and Thin Walled (17.b) Compliant Region Designs
Results
(Rogers et al., sockets
2007) are used. The sockets incorporate thinner socket walls over sensitive regions such as
the distal tibia and the fibula head.
Stage 1 involved one socket for a trans-tibial amputee. The socket was At the same time itsocket
a double-wall was decided to incorporate industry standard hardware for attaching the
pylon. The software developed for stage two incorporated a simple cylindrical adapter for
C
with cantilever compliant regions over the distal tibia and fibula head.
ONCLUSION
foot was used in conjunction with the SLS socket. The prosthesis pylon
The subject’s
wasattachment.
aligned by In
existing
order to test socket designs using a variety of off the shelf hardware it
moving
wasshowed
eccentric cylinders in the pylon adapter. An instrumented gait analysis decidedlittle
to use a commercially available CAD package to add the necessary fixtures.
difference
These fixture designs will eventually be incorporated in the UTHSCSA socket design
The variety of concepts presented in this chapter include a range of viable options
software. The basic socket design was exported from the UTHSCSA socket design software
as a trimmed NURBS (Non Uniform Rational B-Spline) surface to an IGES (Initial Graphics
Exchange Specification) file.
Rhinoceros, a commercially available CAD package was then used to create the design
for realizing the critical socket functions of accommodating radial and longitudinal
features necessary to use off-the-shelf hardware. The IGES file exported from the UTHSCSA
design software is then imported to Rhinoceros and any features needed for pylon attachment
are added. The finished socket design is then written to an STL file for manufacturing.
volumetric change, interfacing with a socket suspension system and other prosthetic
Two basic pylon attachment schemes have been incorporated.
The four holed pyramid adapter is among the most popular components in prosthetics. By
incorporating this adapter into the socket design, any prosthetics facility could assemble a
components, user safety and aesthetics, and methods to combine mechanisms. The most
limb incorporating an SLS socket.
The initial design for the four holed adapter provided a flat surface on the distal end of the
socket to mount a standard pyramid adapter. Two slots are incorporated into the end to
appropriate of these concepts must now be selected for final embodiment and validation.
accommodate aluminium bars with threaded holes that the pylon adapter will be attached to.
The slots are 6 mm beneath the surface. Holes in the SLS socket match up with the threaded
holes in the aluminium bars. The pyramid adapter is attached through the holes to the
Chapter 5 therefore details the procedure undertaken to select the final concepts for
embedded aluminium bars. The disadvantage to this design is that the aluminium bars, while
easily fabricated, are not off-the-shelf items.
An updated design incorporates slots in the distal end of the socket to accept commonly
available 6 mm flange nuts. The slots are shaped to fit snugly to the hexagonal side of the
further analysis.
51
Chapter 5: Concept Selection
Utilizing the concept generation methods described above, many design concepts
were generated for each of the basic socket functions from which a final socket design
could be assembled. However, these concepts must be narrowed down to the most
promising concepts in each area in order to arrive at a final fully embodied volume
adjustable socket design. In order to begin determining which final functional concepts
would best meet the requirements identified during the initial customer needs analysis
(Table 2), an elimination matrix was generated for each of the concept categories. These
matrices provide a quantitative comparison of otherwise qualitative attributes by which
the stronger concepts could be selected. Each matrix consists of rows of concepts whose
performance is scored for each of the performance metrics in the subsequent columns by
assigning a (-) 1, (+) 2, or (++) 3 point score. This three-point scale was selected as it
provides more resolution than a binary scale while still maintaining a simple method for
ranking the concepts. Each point is assigned a qualitative measure of performance for
each criterion by which the concepts can then be ranked. These ordinal rankings are
summarized in individual tables for each functional category (Table 5Table 11). The total
score for each concept is summed across the metrics that are weighted based on their
importance, the more important criteria being given twice the influence in the final score.
These rankings and criteria used were based on the customer needs analysis and research
and serve to provide a base from which to select a final concept in each functional area
for further embodiment and validation. The rankings are not necessarily representative of
empirical data but were intended to help remove bias in the selection process.
52
RADIAL CHANGE
Ten key criteria for selecting the most promising of the radial socket change
concepts were determined based on the project requirements described in Chapter 3. Of
interest in the design of these radial adjustment concepts is the ability of the socket to be
strong, maintain proper alignment, and provide the resolution of volumetric change
needed uniformly around the residual limb. In addition, the adjustment must maintain a
PTB socket design while utilizing SFF. These criteria are summarized in Table 5 that also
includes the ordinal ratings by which each concept was compared. Table 6 gives the final
elimination matrix for the radial change concepts based on these ratings.
53
Criteria Rating Criteria Rating
Strength 3 ++ No obvious Utilize SFF 3 ++ Complex parts
stress concentrations built as one
2 + Possible stress 2 + Simple parts or
concentrations mating surfaces
1 - Apparent stress 1 - SFF not needed
concentrations
Uniform 3 ++ Multiple small Number of Parts 3 ++ Single Part
Change discontinuities (Not including
support structure)
2 + Discontinuities 2 + Multiple
Connected parts
1 - Non uniform 1 - Loose Parts
radial change with
height
Maintains PTB 3 ++ Does not Local Relief 3 ++ Space for relief
Design interfere possible
2 + Slight 2 + Limited space for
interference relief available
1 – Obvious 1 -- No relief
interference
%Change 3 ++ Variable Slim Profile 3 ++ Single wall
(Not including thickness
support structure)
2 + Increments 2 + Double wall
thickness
1 - Limited/large 1 - >2 wall
increments thicknesses
Wear / Fatigue 3 ++ Limited wear Alignment 3 ++ Does not change
and fatigue alignment
2 + Cycling or 2 + Could change
rubbing alignment
1 - Cycling and 1 - Changes
Rubbing alignment
Table 5: Radial Change Selection Criteria and Rating Scale
54
 
Criteria Strength Unif. PTB %Change Wear Utiliz #Parts Local Slim Align. Total
Change Fatigue e SFF Relief Profile
Concept
Accordion - - ++ - - + ++ ++ + - 31
Aperture/ + ++ + ++ - ++ + + + ++ 38
Sliding Plates
Hinged - - + ++ + ++ + + ++ + 36
Sections -
Horizontal
Hinged - ++ + ++ - ++ + + ++ + 34
Sections -
Vertical
Inflation - - ++ ++ + ++ + ++ - - 36
Concepts
Internal + ++ + ++ - ++ + + - ++ 37
Sliding Plates
Pipe Clamp ++ + ++ ++ + + ++ ++ ++ - 46
Pressure + ++ + ++ + ++ + + - + 36
Plates
Removable + + ++ + ++ + - ++ ++ - 38
Wall
Solid Inserts - ++ + ++ - ++ - - - + ++ 37
Scaled Inserts
Spring - - - - ++ - ++ + - - ++ 30
Linear
Spring - - - - ++ - ++ + - - ++ 30
Torsion
Spreader + - + ++ - + + + ++ + 36
Weight 2 2 2 2 2 2 2 1 1 1
Table 6: Radial Change Elimination Matrix 
This elimination matrix demonstrates how the Pipe Clamp (both with or without
inserts), Sliding Plates (both Aperture and Internal), and the Solid Insert concepts were
among the strongest radial change concepts.
LONGITUDINAL CHANGE
As with the radial change concept elimination matrix, key criteria for selecting the
most promising of the longitudinal socket change concepts were determined based on the
project requirements described in Chapter 3. These criteria are similar to those for radial
change but have been adjusted to reflect specific application to longitudinal change. The
criteria are summarized in Table 7, which also includes the ordinal ratings by which each
55
concept was compared. Table 8 gives the final elimination matrix for the longitudinal
change concepts based on these ratings for the concepts.
Strength 3 ++ No obvious Utilize SFF 3 ++ Complex parts
stress concentrations built as one
2 + Possible stress 2 + Simple parts or
concentrations mating surfaces
1 - Apparent stress 1 - SFF not needed
concentrations
%Change 3 ++ Variable that Number of 3 ++ Single Part
can be made Parts
incremental
2 + Increments 2 + Multiple Connected
parts
1 - Limited/Large 1 - Loose Parts
increments
Wear / Fatigue 3 ++ Limited wear Slim Profile 3 ++ Single wall
and fatigue (Not including thickness
support
Structure)
2 + Cycling or 2 + Double wall
rubbing thickness
1 – Cycling and 1 - >2 wall thicknesses
rubbing
Change 3 ++ Along length
Location
2 + In socket
1 - Lengthen Pylon
Table 7: Longitudinal Change Selection Criteria and Ranking Scale
56
Criteria Strength %Change Wear / Change Utilize Number Slim Total
Concept Fatigue Location SFF of Parts Profile
Interlocking - + + ++ ++ - - 18
Rings
Plunger + ++ - + ++ ++ ++ 24
Solid Inserts - ++ + ++ + - - ++ 20
Height Spacers
Threaded Wall ++ ++ - ++ ++ ++ + 25
Push Button - + + - + + + 18
Pylon
Adjustment
Safety Pin ++ + + - - - ++ 20
w/through
holes
Weight 2 2 2 2 2 1 1
Table 8: Longitudinal Change Elimination Matrix 
Based on this elimination matrix, the Plunger and Threaded Wall concepts were
among the strongest longitudinal change concepts.
FASTENERS
The criteria used in the elimination matrix for the Fastener concepts were also
selected based on the requirements of the project from Chapter 3. The strength of these
mechanisms is of particular importance as their strength will largely determine the
strength of a modular socket design. In contrast to this, the force to actuate these
mechanisms must be reasonably expected from the target population that includes
adolescents. Table 9 summarizes these criteria with their ordinal ratings. The completed
elimination matrix is shown in Table 10.
57
 
Strength 3 ++ No obvious %Change 3 ++ Continuous
stress concentrations
2 + Possible stress 2 + Increments
concentrations
1 - Apparent stress 1 - Limited/Large
concentrations increments
Wear / Fatigue 3 ++ limited wear and Force to Actuate 3 ++ Finger Tight
fatigue
2 + cycling or rubbing 2 + Significant Manual
Force
1 - rubbing and 1 - Significant Force
cycling Requiring Tooling
Utilize SFF 3 ++ complex parts Slim Profile 3 ++ Single wall
built as one (Not including thickness
support
structure)
2 + simple parts or 2 + Double wall
mating surfaces thickness
1 - SFF not needed 1 - >2 wall thicknesses
Table 9: Fastener Selection Criteria and Ranking Scale 
Criteria Height/ Strength Wear / Utilize %Change Force to Slim Total

Concept Radial Fatigue SFF Actuate Profile
Hinge Fastener Both - + + ++ ++ ++ 20
Horizontal Bands Both + - - ++ ++ + 18
Locking Fastener Both + + ++ - ++ - 19
Push Button Both - + ++ - + + 16
Release
Slider Fastener Radial - + + ++ ++ + 19
Ratchet Fastener Both ++ ++ ++ + ++ + 25
Threads Both ++ + + ++ + + 21
Screw Expander Both ++ + + ++ + - 20
Weight 2 2 1 1 2 1
Table 10: Fastener Elimination Matrix 
This elimination matrix demonstrates how the Ratchet, Threaded, and Hinge
fasteners were the most promising fastener concepts.
58
INTERFACE WITH SOCKET COMPONENTS
Again, the criteria used in the elimination matrix for concepts interfacing with
other socket components, particularly the pylon, were selected based on the requirements
of the project from Chapter 3. These criteria are very similar to those required for the
radial adjustment concepts as alignment and strength are important. As fine adjustments
will be required here by a prosthetist to achieve proper socket alignment, the amount of
change available is of particular importance. Table 11 summarizes these criteria and
describes their ordinal ratings. The completed elimination matrix is show in Table 12.
Wear/Fatigue 3 ++ limited wear %Change 3 ++ Large Alignment
and fatigue
2 + cycling or 2 + Limited Alignment
rubbing
1 - rubbing and 1 - None w/out
cycling permanent adjustment
Ease of Use 3 ++ Universally # Components 3 ++ No Additional
known
2 + Analogous 2 + Few Additional
1 - New 1 - Multiple Additional

Technology
Utilize SFF 3 ++ complex parts
built as one
2 + simple parts or
mating surfaces
1 - SFF not needed
Table 11: Socket Interface Selection Criteria and Ranking Scale
59
Criteria Wear/ Ease of Utilize %Change # Components TOTAL
Concept Fatigue Use SFF
Threaded/Through ++ ++ + ++ - 20
Holes for universal
adapter
Integrated Pyramid - ++ ++ ++ + 20
Adapter
Rigid Opening w/set - + - + + 13
screws
Monolimb design + - + - ++ 15
Weight 1 2 2 1 2
Table 12: Socket Interface Elimination Matrix 
The Threaded/Through Holes for a universal adapter and the Integrated Pyramid
adapter were therefore among the most promising of the pylon integration concepts.
SAFETY AND AESTHETICS
A specific elimination matrix for the safety concepts has not been generated, as
many of the concepts are dependent on the final concepts selected for the radial,
longitudinal, fastener, and interface concepts. Therefore, these concepts will be selected
as needed based on the final design, incorporating the functional concepts selected.
CONCEPTS SELECTED FOR FURTHER DEVELOPMENT
These elimination matrices were useful in narrowing the broad range of design
concepts to a manageable few for further analysis. As shown, the preferred radial change
concepts include the Pipe Clamp (both with or without inserts), Sliding Plates (both
Aperture and Internal), and the Solid Insert concepts due to their potential to provide
robust mechanisms for incremental radial change. Similarly, the Plunger and Threaded
Wall longitudinal adjustment concepts were among the strongest. Connection of the
prosthetic socket to other socket components was narrowed down to the
Threaded/Through Holes for a universal adapter and the Integrated Pyramid adapter due
60
to their ease of use and amount of available alignment. Incorporation of these concepts
into a single socket design requires the use of fasteners. Of those generated, the Hinge,
Ratchet, and Threaded fasteners were the most promising concepts.
These concepts therefore will be further pursued in design embodiment towards a
final socket design. However, the possible full socket design relies on the ability of the
compensation or integration methods to be fastened to each other. Therefore the design of
the Threaded and Ratchet Fastener mechanisms will be the initial focus of analysis. This
will help to determine which radial change, longitudinal change, and socket component
integration methods will be the most plausible as their functionality and strength will
likely rely on the design of these fasteners.
61
Chapter 6: Design Embodiment and Verification Results
This chapter presents the results of analyzing the performance of several

promising subsystem concepts for the volume compensating prosthetic socket. These
concepts were generated using methods such as brainstorming and design by analogy
methods as described in Chapter 4. Four categories of subsystem design concepts were
generated using this process, including designs for radial and longitudinal volumetric
change, interfacing with a socket suspension system and other prosthetic components,
user safety and aesthetics, and fasteners. The fasteners are the focus of the remainder of
this thesis as they provide the means by which possible radial and longitudinal concepts
can be incorporated into a final socket design. Among the fastener concepts generated,
two promising fastening methods were identified: a hook style ratchet connection and a
basic threaded fastener. These fastener concepts were common to several of the adaptable
socket concepts. Development of these fasteners will enable the embodiment of a full
transtibial SLS prosthetic socket that will provide both radial and longitudinal volume
compensation for pediatric patients in developing countries. This chapter describes the
design of test specimens of these concepts. The designs generated are analyzed here to
ensure adequate strength and functionality and therefore feasibility of development of
socket concepts that utilize these fasteners.
THREADED FASTENER DEVELOPMENT
Specimens were designed for verification of a theoretical threaded fastener model

for use in a volume adjusting socket. The theoretical model of the threaded specimens is
based on threaded fastener design principles for a power screw with square threads
(Shigley, Mischke, & Budynas, 2004). The design and validation process followed for
the development of a theoretical fastener model included the basic steps of:
62
• Initial specimen design based on theoretical models and preliminary builds
to determine basic geometry.
• Initial specimen testing for geometric accuracy, load capacity, and model
accuracy.
• Specimen redesign based on results of initial specimen tests.
• Redesigned specimen testing for geometric accuracy, load capacity, and
model accuracy.
1. Threaded Fastener Theoretical Model
Illustrated in Figure 24, the threaded fastener specimens include an externally

threaded bolt and corresponding internally threaded end cap. On the opposite ends of
each threaded component is a tab to be secured inside the clamps of a tensile testing
machine. As growth and dimensional accuracy is an issue with parts manufactured using
SLS, a clearance c must be provided between mating surfaces to ensure that the
specimens are functional. Due to the added clearance, the actual pitch p of the samples is
not equivalent to twice the thread thickness t as is typically used in thread design. The
pitch is instead equal to twice the thickness plus twice the clearance. The number of
engaged threads nt is initially set at seven as it has been experimentally shown that the
seventh tread is the first thread that does not experience load (Shigley et al., 2004). The
minor diameter dr and t however are unknown and must be determined.
63
Figure 24: Basic Threaded Specimen Geometry
Initial values for dr, and t to be used in testing were obtained using the
relationship between these dimensions at failure, which occurs when the stress at the base
of the threads exceeds the yield strength of the material. The bending stress at the base of
the threads due to the moment caused by the applied axial force, F, in Newtons is
(Shigley et al., 2004):
(1)
By setting this stress equal to the yield strength of the material and solving for the
minor diameter, the relationship between dr and t at failure becomes:
(2)
Using this relationship, and thread thicknesses greater than the previously
identified minimum feature size of .5 mm, specimens were modeled using the solid
modeling software Rhinoceros®. As the maximum applicable force of the available
tensile testing machine is 5000 N, the modeled samples were designed to fail at 4000 N
64
(3300 Series, 2007). The geometries determined using this model are summarized in
Table 13.
Set Pitch (p) Minor Diameter (dr) Thread Thickness (t)

A 2.2 15 0.6
B 2.5 12.5 0.75
C 2.8 10 0.9
Table 13: Threaded Fastener Specimen Dimensions (All units mm)
To verify the functionality of threaded specimens manufactured using these initial

values and determine a minimum clearance, a series of preliminary builds was completed.
One initial build included a full-scale model of these threaded fastener mechanisms
designed for a potential application as the longitudinal height adjustment for pylon
attachment. The final testing specimens were designed as scaled versions of this
mechanism as the full-scale mechanism, according to the theoretical model, would not
fail at loads available from the 3300 Series Instron® tensile testing machine used in this
study. The larger size of the full-scale model ensures the specimen does not bend nor
buckle during loading. In addition to a bending moment, it was determined that the full-
scale mechanism must endure a 2500 N axial force. These scaled fastener testing
specimens are designed to focus on the strength of thread designs under this axial loading
condition. The magnitude of the anticipated axial force was derived from the maximum
amount of force that could be exerted by a child while ambulating. This large magnitude
is likely to occur while in a jumping or counter movement and can be as large as six
times the user’s body weight. For a 90th percentile 8 year old male, body weight is
approximately 42 kg (92.3 lb) which is therefore a force of nearly 2500 N (McDowell et
al., 2006).
65
A 3D Systems® Vanguard HiQ SLS machine was used to manufacture the
threaded fastener test specimens. In the build setup, ASTM D638 tensile bars were also
included for comparison to ensure that the resulting build is achieving published material
properties for the material used. All part and build parameter settings were values used in
previously successful builds completed during a Design of Experiments used to optimize
these parameters, described in more detail in Montgomery (2009). Care was taken during
arrangement of the parts in the build setup to ensure cylindrical parts were built vertically
and portions of the build volume where known part curling issues occurred were avoided.
The material used for this study was Rislan® D80 (Nylon 11) powder manufactured by
Arkema. Equal parts virgin and overflow powder were used.
The preliminary builds resulted in appropriate geometry necessary for functional
specimens and established in-build part orientation requirements. The builds also
confirmed a clearance of .5 mm between mating surfaces was necessary. This
information, as well as the same build setup, was utilized in the manufacture of two
specimens from each set described in Table 13 for this preliminary study (Figure 25).
Figure 25: Final Threaded Specimen
66
2. Threaded Specimen Testing
Manufactured parts were tested for geometric accuracy, load capacity, and model
accuracy. Geometric accuracy was determined by comparing the measured geometry of
the sintered test specimens with the intended geometry as modeled. Load capacity and
model accuracy were established through testing of manufactured parts based on a
modified version of the ASTM D638. Fastener test specimens were pulled in tension to
failure at a rate of 0.5 mm/min (Figure 26). For the test, an Instron® 3345 single column
tensile machine with a load capacity of 5kN was used to obtain a load versus elongation
curve for each sample.
Figure 26: Threaded Specimen Testing Setup
The geometric accuracy of the threaded testing specimens was determined by

measuring the primary dimensions, t, dr, and p prior to loading and is summarized in
Figure 27. This figure displays the average percent difference for all specimens for each
67
of the varied dimensions. Error bars are included and show one standard deviation from
the mean.
Figure 27: Geometric Accuracy of Threaded Fasteners
The nearly 24% increase in the thickness of the treads is the greatest discrepancy
between the nominal dimensions and the measured values. This implies that there are
higher levels of inaccuracy when attempting to build small features such as the threads on
these specimens.
Each of the six threaded specimens was loaded to failure and load versus
extension curves were obtained (see Figure 28). Each curve represents a single specimen
and the point where the specimen yielded and broke are marked. Of the specimens tested,
three of the specimens exceeded the intended failure point of 4000 N (bold horizontal
line). However, only one of these three specimens actually failed in the threads. The
remaining five yielded in the tabs by which the specimen was clamped in the testing
apparatus. In addition, all of the specimens did not yield until more than 2500N. This is
promising as an intended application for these fasteners will likely experience a load of
2500 N.
68
Figure 28: Load vs. Extension – Initial Threaded Specimens
As all specimens were designed to fail at 4000 N, the initial prediction of

specimen failure based on the threaded fastener model described above was inaccurate.
The model predicted that the specimens, labeled according to their corresponding
dimension set A, B, or C described in Table 13, would fail at ~4000 N as the stress on the
threads would exceed the yield strength of the material (Row 2 of Table 15). The yield
strength of the material used was 48.3 MPa based on tensile test of the additional tensile
test specimens included in the build (Table 14).
Tensile Standard Standard

Direction Modulus
Strength Deviation Deviation
X 49.12 0.45 1651.09 119.52
Y 47.49 0.95 1618.13 143.90
X and Y 48.30 1.11 1634.61 125.91
Table 14: Material Property Results - Test Build 11
lxix
1 These material property results differ from typical values published by CES Edupack 2008: Tensile
strength of 55.2-65.5 MPa and Young’s Modulus of 1240-1310 Mpa. This is likely the result of using
higher than recommended build parameter settings, such as part bed temperature.
69
Only one specimen actually failed, but at 740 N above the anticipated limit. However,
when the actual geometry of the specimens, which included the larger thread thicknesses,
and the maximum load achieved were used in the model, the failure predictions were
accurate and the only specimen predicted to fail did (Row 3 of Table 15).
A1 A2 B1 B2 C1 C2
Max Load (N) 4740 4550 3690 4130 3260 2850
Expected σ (MPa) 60.63 60.63 58.21 58.21 60.63 60.63
Actual (MPa) 61.58 55.61 42.36 50.07 38.65 33.78
Failure? Y N N N N N
Failure Marginal No
Failure
Table 15: Threaded Model Results
Two specimens are considered ‘Marginal’ due to the fact that they did not fail
even though the stress on the treads according to the model exceeded the measured yield
strength of the material. However, these calculated stress values are close to the yield
strength of the material and therefore it is uncertain whether they would have failed
shortly in the threads if it were not for the failure in the tabs.
3. Final Threaded Fastener Design
A second iteration of the threaded specimens was completed in order to further

verify the accuracy of the theoretical strength model of the threaded fastener specimens.
Modifications to the experimental specimens focused primarily on ensuring failure
occurred in the threads of the specimens rather than in the pull-tabs. In addition,
adjustments were made for growth that occurred in the first round of experimentation.
The basic shape of the redesigned threaded fastener testing specimens remained
unchanged from that used in the first round of experiments (Figure 24). However, as the
70
specimens were failing at loads approaching the maximum allowable for the Instron
tensile testing machine, the dimensions were modified to ensure that the specimens failed
at 3000 N based on the theoretical model rather than 4000 N. This also theoretically helps
ensure that failure occurs in the threads of the specimens rather than in the tabs. To
accomplish this, the number of threads on the specimens was reduced from seven to four
(Figure 29).
Figure 29: Redesigned Threaded Specimens
In addition, the geometry was modified to compensate for growth in the thickness
of the threads. However, as the threads were already close to the minimum functional
feature size manufacturable using our SLS machine, the amount of growth experienced in
the first round of experiments is expected to occur on these parts. This amount of growth
then is accounted for in the theoretical model described above. The final dimensions
anticipated based on the theoretical model are listed in Figure 16. These samples were
manufactured following the same procedures above.
71
Set Pitch (p) Minor Diameter (dr) Thread Thickness (t)
D  2.2  15  0.74 
E  2.5  12.5  0.93 
F  2.8  10  1.12 
Table 16: Final Threaded Specimen Dimensions
4. Final Threaded Specimen Testing Results
The redesigned threaded specimens were again tested for geometric accuracy,
load capacity, and model accuracy according to the methods used to determine the
accuracy of the initial threaded specimen design. Five specimen pairs were manufactured
for each of the three geometries desired and were used in testing.
Figure 30 displays the final change in dimensions of the sintered parts as
compared to the anticipated dimensions. All three major dimensions experienced some
growth; however, the greatest growth was again in the tooth thickness with a maximum
percent difference of 10.75% and a mean of 4.75%. Error bars are included and show one
standard deviation from the mean.
9% 
8% 
% Change in Dimension 
7% 
6% 
t 
5% 
dr 
4% 
p 
3% 
2% 
1% 
0% 
Figure 30: Geometric Accuracy of Redesigned Threaded Fasteners
72
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73
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loaded to 3000N is 64.81 MPa. This is greater than the yield strength of the material,
which was 48.84 MPa (average of X and Y directions, Table 17). Thus the specimens are
expected to fail by 3000 N.
Tensile Standard Standard
Direction Modulus
Strength (MPa) Deviation Deviation
X (top and
48.69 0.64 1670.82 225.66
bottom)
Y (top and
48.99 0.96 1572.97 48.06
bottom)
X and Y 48.84 0.81 1621.89 166.54
Z 33.08 5.76 1730.71 200.84
Table 17: Material Property Results - Test Build 2
The actual stress applied to the specimens based on the load at failure and the
actual specimen geometry was also determined for the final specimens manufactured
using the theoretical model. The stress on the threads, even compensating for actual loads
and measured dimensions, remained above the yield strength of the material, the lowest
being 49.01 MPa, within a standard deviation of the mean tensile strength measured for
the build, 48.84 MPa. Therefore all specimen pairs were still predicted to fail based on
the theoretical model. However, as shown in Table 18, only 60% of specimen pairs failed
as predicted. Only 13.33% of the specimens tested, failed such that they were no longer
functional. The resulting load and anticipated bending stress values on the threads used in
determining whether the model and actual results agree are summarized in Table 18.
75
D  E  F 
Average Max Load (STDEV)  2,489.75 (612.31) 3,059.81 (599.28) 2,415.09 (796.75) 
Expected σ (MPa)  64.81  64.81  64.81 
Actual σ (MPa)   50.57  58.11  49.01 
# of Failures in set 4 of 6  2 of 6  3 of 6 
Failure Marginal No Failure
Table 18: Redesigned Threaded Fastener Model Results
5. Threaded Fastener Conclusions
Though not all of the specimens failed at the expected load, these specimens have
demonstrated how threaded fasteners under axial loading conditions can sustain loads
greater than predicted by the theoretical model as well as the anticipated load of 2500 N.
The implications of these results are summarized in more detail in Chapter 7.
RATCHET FASTENER DEVELOPMENT
Test specimens were also developed to determine an appropriate model of the

ratchet fastener for use as a tool for designing an appropriate ratchet style fastener in a
final socket design. The same basic steps were followed in the theoretical model
development for the ratchet fasters as was implemented in development of the threaded
fastener model.
1. Ratchet Fastener Theoretical Model
The basic geometry of the ratchet fastener is illustrated in Figure 34.
76
Figure 34: Basic Ratchet Specimen Geometry
Seven dimensions define this geometry that creates a two-part removable hook
style fastener test specimen. These include the overall length L, width W, tooth face width
b, tooth thickness T, internal tooth angle θ, external tooth angle φ, and the tooth height H.
The length L was set such that the total length of the specimen when both halves are
joined is 145 mm. A width W of 5 mm and tooth face width b of 38.1 mm were selected
based on the potential inclusion of this fastener in a section of the wall (a potential
application is described in more detail in Chapter 7). For all specimens, φ was five
degrees less than the angle θ, such that the teeth will lock smoothly and provide clearance
between successive teeth when used in a ratcheting application. The remaining

dimensions were varied to determine their impact on the strength of the socket in order to
determine a viable ratchet design.
The final specimen geometry for testing was determined using methods similar to
those used to determine the threaded specimen geometry. As with the threaded
specimens, a series of preliminary builds was completed to determine minimum feature
size as well as to identify issues with growth (Figure 35).
77
Figure 35: Ratchet Sample Design Iteration (Bottom Final)
Several arrangements of the internal tooth angle θ and tooth thickness T were
selected for testing of the ratchet fastener. For the initial test specimens, the angle and
thickness were varied while the tooth height was determined by adjusting the tooth length
to account for build growth and provide a fixed effective tooth length of 5 mm. The
specimen dimensions used are summarized in Table 19. These parts were included in the
same build as the initial threaded specimens and three specimen pairs for each set were
manufactured for testing.
Set Length, L (mm) Height, H (mm) Fillet, R (mm) Angle, θ (deg)

A 77.9 3.4 1.25 35
B 77.31 3.09 1.25 30
C 76.9 2.6 1.25 25
D 76.62 2.62 1.5 25
E 77.59 2.33 1 25
Table 19: Ratchet Specimen Dimensions
In addition, since these specimens are intended for use in optimizing the strength
of the fastener while minimizing its size, a Finite Element Model (FEM) was developed
78
using COSMOSWorks® software to predict the strength of the proposed ratchet design.
This FEM consisted of a solid model developed using SolidWorks® according to the
desired dimensions of the ratchet specimen. As the specimens were clamped in the tensile
testing machine, the samples were modeled to a length that did not include the end fixed
in the clamps (Figure 36).
Figure 36: Ratchet Specimen Tensile Testing Setup
Therefore the model boundary conditions include fixed constraints at the end of the
specimen where the clamp would have been as well as a pressure load, oriented parallel
to the length of the specimen, distributed over the contacting surface area of the tooth.
Figure 37 illustrates the basic constrained model used.
79
Figure 37: Constrained Ratchet FEM
The model was then meshed for a solid model static analysis using
COSMOSWorks®. An iterative solution method for large displacements was used as the
likely distance traveled by the tooth in testing was larger than the tooth thickness itself. A
Convergence Plot generated by COSMOSWorks® was used to ascertain that the model
was converging during the iterations. Figure 38 is an example of the convergence plots
reviewed.
Figure 38: Example Convergence Plot

80
This FEM was used to obtain load vs. extension curve points for comparison with
actual experimental testing results. This comparison helps to verify the accuracy of this
model for use in designing ratchet style mechanisms for a final adaptive socket design.
One such load-extension curve point to be considered is at an anticipated load
value. Analysis of the extension of the specimen at this load helps to determine whether
the selected range of geometries is appropriate. This anticipated load was determined by
approximating a socket as a thin walled cylindrical pressure vessel and solving for the
hoop stress, and therefore tension, in a 38.1 mm (1.5 in) section of the socket wall. The
assumption of using a thin walled pressure vessel was verified by ensuring that the ratio
of the wall thickness to the diameter is small. For a wall thickness of 5 mm used in
previously manufactured SLS sockets and a mean internal diameter of 98 mm determined
from a scan of an adult male patient’s residuum, this ratio is 0.05 and therefore the thin
wall approximation will be used. The equation for the stress in a thin wall pressure vessel
to be used is (Shigley et al., 2004):
" = Pr t (3)
where P is the pressure inside the socket, r is the radius approximation of a residual limb,
and t is the wall thickness of the socket.
! Knowing that the tension in the section of the
socket wall is equivalent to the stress σ over the cross-sectional area of interest, the final
equation for the anticipated load in the socket wall is: 
Pr
T= (t " #x) = Pr #x (4)
t
Using the maximum stress level of 0.254 MPa recorded by Goh et al. for an adult
male below-knee amputee and distributing it uniformly over the area of interest, Δx of
!
38.1 mm, this equation gives an anticipated maximum load of 47.5 N (2003). This load
value is therefore used as a minimum strength value for the ratchet specimens to
81
determine their applicability for inclusion in a final adaptable socket design. At this load,
the stresses expected on the ratchet teeth for the initial specimens, as predicted by the
theoretical model, are summarized in Table 20.
Angle (Deg) Tooth Thickness (mm) Extension (mm) Stress (MPa)
35 1.25 0.33 2.98
30 1.25 0.28 2.70
25 1.25 0.25 2.86
25 1.5 0.26 2.75
25 1 0.23 1.89
Table 20:Anticipated Extension and Load on Ratchet Specimens Based on FEA
As these values are significantly less than the yield strength of the material, the
initial values selected for L, H, T, and θ are further supported as valid initial choices for
experimental testing.
2. Ratchet Specimen Testing
Testing of these ratchet specimens included determination of geometric accuracy,

load capacity, and model accuracy. Geometric measurements and load versus elongation
curves were obtained for the samples using the testing method described previously.
As with the threaded specimens, the manufactured ratchet test specimens were
also measured for comparison with the intended values for the H, T and L dimensions.
The percent difference between the expected and measured values for each of these
dimensions across all specimens are averaged and displayed with error bars of one
standard deviation in Figure 39. The greatest differences are found in the smaller part
features, H and T. As both of these dimensions experienced shrinkage, indicated by the
negative percent difference, these tooth features are too small at the point of the tooth and
are therefore not building even though modeled. This was particularly noticeable in the
82
sample set E where the tooth thickness T was the smallest, 1.00 mm. The length of the
tooth for the specimens from set E were shorter due to the width of portions of the tooth
point being less than the minimum feature size. This resulted in an average decrease in
the overall height of the tooth by 52% for these specimens, while the other sample sets
(A, B, C, and D) ranged from 16-32% difference in height.
Figure 39: Geometric Accuracy of Ratchet Fasteners
In addition to measuring the geometric accuracy of the ratchet specimens, the load
capacity of the specimens was determined using the testing method described above.
Each of the 15 specimen pairs was tested to failure using the Instron® 3345 tensile testing
machine and a load vs. extension curve was obtained (Example graph in Figure 40).
83
!
! " # $ % & ' ( ) *
3456789,7/0::2
;<6=9:67/%/5,/'
&!!
%!!
+,-./012
;<6=9:67/>
$!!
%
&
#!! '
"!!
!
! " # $ % & ' ( ) *
3456789,7/0::2
Figure 40: Sample Experimental Load vs. Extension Curve (30 Deg Internal Angle
Ratchet Specimens)
The maximum load at yield, zero slope on the curve, was obtained and then
plotted versus the intended angle θ and tooth thickness T (Figure 41). All samples failed
?-@6/"/,A/%
at nearly six times the maximum load of 47.5 N anticipated for the intended application
of these fasteners.
375 
355 
Load (N) 
335 
315 
295 
275 
1  1.25  1.5 
Expected Thickness (mm) 
Figure 41: Load vs. Tooth Thickness (Left) and Angle (Right)
The accuracy of the FEA model described above was then determined by
comparing the performance of the model at points along the load vs. extension curve for
each specimen. Material properties used were the Nylon 11 material properties for tensile
g
strength (48.3 MPa), modulus of elasticity (1635 MPa), and density (0.97 cm3 )
84
!
determined from tensile bars included in the build tested according to ASTM D638
(Table 14). The Poisson’s ratio of 0.4145 used was the average ratio value available from
CES EduPack Software produced by GRANTA (PA, 2008). Average actual specimen
dimensions obtained from measurement of specimens while ascertaining the geometric
accuracy were used in verifying this model. Using the FEM, load – extension pairs were
obtained at four different load values, one at yield, three others equally spaced along the
linear elastic range of the curve, and one at the anticipated load of 45.7 N. These were
then compared with the corresponding average load – extension pair on the experimental
curve (Figure 42 & Figure 43). The actual experimental load – extension curve points
used for comparison with the model were the average extension achieved by the three
tested specimen pairs at the desired load.
500.00 
450.00 
400.00 
350.00 
Model 1.00 
Load (N) 
300.00 
Actual 1.00 
250.00 
200.00  Model 1.25 
150.00  Actual 1.25 
100.00  Model 1.5 
50.00  Acutal 1.5 
0.00 
0.00  0.50  1.00  1.50  2.00  2.50 
Extension (mm) 

Range of Tooth Thicknesses (1, 1.25, and 1.5 mm)
85
500 
450 
400 
350 
Model 25 1.25 
Load (N) 
300 
Actual 25 1.25 
250 
200  Model 30 1.25 
150  Actual 30 1.25 
100  Modle 35 1.25 
50  Actual 35 1.25 
0 
0.00  0.50  1.00  1.50  2.00  2.50 
Extension (mm) 

Range of Ratchet Internal Tooth Angles (25, 30, and 35 Degrees)
In order to quantify the amount of deviation of the theoretical model from the
experimental data, a relative difference ratio was used. This ratio is defined by:
x − xpredicted 
RD = abs actual  ×100%
 max(xactual )  (5)
where the difference between the extension value calculated by the model, xpredicted, for a
given load is subtracted
€ from the measured value at the same load. This difference is
normalized to the maximum measured extension for the particular specimen. This
normalization enables comparison of results across samples as well as along the load vs.
extension curve. Normalization is necessary as the magnitudes of the extension value
differences are different across specimen designs as well as along the curve. Figure 44
shows the increasing trend of the relative difference percentages with respect to applied
load with the load at yield circled.
86
40% 
35% 
Relative Difference 
30% 
25%  30Deg 1.25mm 
35Deg 1.25mm 
20% 
25Deg 1.25mm 
15% 
25Deg 1.5mm 
10% 
25Deg 1.00mm 
5% 
Load at Yield 
0% 
0  100  200  300  400  500 
Load (N) 
Figure 44: Relative Percent Difference of Ratchet FEM Results from Experimental Data
vs. Load (Load at yield circled)
As shown in these graphs, the deviation of the model from the experimental data
is greatest as the load on the ratchet tooth approaches the yield strength of the material.
At this load the model deviates 13-35% from the experimental data. In the linear portion
of the curve however, the difference between the theoretical and experimental data is less
than 10%.
3. Final Ratchet Fastener Design
Based on the results of the initial ratchet testing, further improvements were
needed to address growth/shrinkage issues, to investigate strengthening the specimens,
and to determine the impact of changing the direction of loading on the ratchet tooth.
The general shape of the ratchet specimen was maintained from the previous specimens,
however one major adjustment was made in an attempt to strengthen the specimens and
ensure full part manufacture. Instead of having the ratchet tooth come to a point as in the
87
previous design, a fillet with radius R was added to the tip of the ratchet tooth as well as
along the crease (Figure 45).
Figure 45: Redesigned Ratchet Specimen Geometry
This area along the crease in the previous design was already empty as the
thickness of the other tooth, when fitted together, prevented a tight fit. Matching the
radius of the fillet in the crease with that on the tooth edge was theorized to help the
specimens mate completely and direct more of the load into the stronger area at the base
of the tooth. Use of a minimum fillet radius equal to the minimum feature size previously
discussed (0.5 mm) helps ensure that all features are larger than the minimum feature size
and will therefore sinter properly.
A range of values for the internal tooth angle θ and tooth fillet radius R were
selected for testing the redesigned ratchet fastener using methods similar to those
described previously (Table 21).

F 80.65 4.82 .5 35
G 74.8 4.41 .5 30
H 73.28 4.07 .5 25
I 71.87 4.52 .75 25
J 76.02 3.15 .25 25
Table 21: Redesigned Ratchet Dimensions
88
Initial verification of the specimen geometry using the FEM described previously
showed that the stress on the tooth at the anticipated load of 47.5 N had a safety factor
greater than the minimum desired (Table 22).
Angle (Deg) Fillet Radius (mm) Extension (mm) Stress (MPa)

35 0.5 0.43 2.61
30 0.5 0.32 3.15
25 0.5 0.22 1.99
25 0.75 0.28 2.61
25 0.25 0.30 2.79
Table 22: Anticipated Extension and Stress on Redesigned Ratchet Specimen Based on
FEA
As the current testing specimen for the ratchet fastener only accounts for one
direction of applied force, an additional specimen for determining the amount of force
required to make the specimens slip in another loading condition also provides useful
information. This testing specimen was designed using the same ratchet tooth geometry
as the redesigned ratchet but the length of the specimen was reoriented 90° from the
original direction of pull (Figure 46).
89
Figure 46: Rotated Redesigned Ratchet Specimen Geometry
A range of values for tooth angle θ and tooth fillet radius R similar to those used
in the redesigned ratchet sample described above was selected and deviates only in the
length L. These values and the corresponding lengths and tooth heights are summarized
in Table 23.
F 80.65 4.73 .5 35
G 74.8 4.41 .5 30
H 73.28 4.07 .5 25
I 71.87 4.52 .75 25
J 76.02 3.15 .25 25
Table 23: Rotated Redesigned Ratchet Specimen
Four specimen pairs were manufactured for each of the five geometries desired in
both orientations for a total of 40 ratchet specimen pairs. These specimens were built in
90
the 3D Systems® Vanguard HiQ SLS machine using the Nylon 11 material and machine
and material parameter settings previously determined.
4. Final Testing Results
The redesigned and rotated ratchet specimens were also tested following the
procedures previously described for testing ratchet specimens, the geometric accuracy,
load capacity, and model accuracy. To determine their geometric accuracy, the
redesigned and rotated ratchet specimens were measured for comparison with the
intended values for the H, T and L dimensions (Table 21 & Table 23). The percent
difference between the expected and measured values for each of these dimensions across
all specimens are averaged and displayed with error bars of one standard deviation in
Figure 47. Again, the greatest differences are found in the smaller part features, H and T.
The average values for each of the major dimensions obtained from these measurements
were used in the final FEA discussed later.
50%  50% 
40%  40% 
30%  30% 
H  H 
20%  T  20%  T 
L  L 
10%  10% 
0%  0% 
‐10%  ‐10% 
Figure 47: Geometric Accuracy - Redesign (Left) and Rotated Redesign (Right)
In addition to measuring the geometric accuracy of the redesigned ratchet

specimens, the load capacity of the specimens was determined using the testing method
described above. Each of the 40 specimen pairs was tested to failure and load vs.
91
extension curves were obtained. The average maximum load at yield, zero slope on the
curve, for each sample set was obtained and then plotted versus the intended angle θ and
tooth thickness 2*R (Figure 48 & Figure 49).
1200  1200 
1000  1000 
Load (N) 
Load (N) 
800  800 
600  600 
400  400 
200  200 
0  0 
25  30  35  0.5  1  1.5 
Expected Angle (Degrees)  Expected Diameter (mm) 
Figure 48: Load Capacity of the Redesign Ratchet vs. Angle (Left) and Fillet Diameter
(Right)
300  300 
250  250 
Load (N) 
200 
Load (N) 
200 
150  150 
100  100 
50  50 
0  0 
25  30  35  0.5  1  1.5 
Expected Angle (Degrees)  Expected Diameter (mm) 
Figure 49: Load Capacity of the Rotated Redesign Ratchet vs. Angle (Left) and Fillet
Diameter (Right)
All of the redesigned ratchet specimen pairs failed at more than nine times the
maximum anticipated load of 47.5 N for the intended application of these fasteners.
However, not all of the rotated redesign ratchet specimen pairs failed at loads above
anticipated. The 30° and 35° specimens failed on average at or below the anticipated load
of 45.7 N.
92
The final area of testing includes the further verification of the FEM developed
previously. This was accomplished by again comparing the load vs. extension curves
generated by the FEA and the experimental results for the redesigned ratchet fastener
specimens. As before, mean dimension values obtained during the geometric accuracy
verification process were used in the FEM and extension and von Mises stresses were
obtain at four different load values, one at yield and three others equally spaced along the
linear elastic range of the curve. Material properties used were the Nylon 11 material
properties for tensile strength (48.43 MPa), modulus of elasticity (1622 MPa), and
g
density (.97 cm3 ) determined from tensile bars included in the build tested according to
ASTM D638 (Table 17). The Poisson’s ratio of .4145 used was the average ratio value
!
available from CES EduPack Software produced by GRANTA (PA, 2008). Figure 50 and
Figure 51 show the resulting theoretical and experimental load vs. extension curves.
1400 
1200 
1000 
Model r=.25 
Load (N) 
800 
Actual r=.25 
600  Model r=.5 
Actual r=.5 
400 
Model r=.75 
200 
Actual r=.75 
0 
0  1  2  3  4  5  6  7 
Extension (mm) 

Experimental Data - Range of Fillet Radii (0.25, 0.5, and 0.75 mm)
93
1400 
1200 
1000 
Model 25 r=.5 
Load (N) 
800 
Actual 25 r=.5 
600  Model 30 r=.5 
400 
Model 35 r=.5 
200 
0 
0  1  2  3  4  5  6  7 
Extension (mm) 

Experimental Data - Range of Internal Tooth Angles (25, 30, and 35
deg)
The relative difference of the model curves from the experimental data is
presented in Figure 52. Again, a similar trend where the relative difference increases as
the specimens begin to yield is seen.
94
35% 
30% 
Relative Difference 
25% 
35Deg 0.5mm 
20% 
30Deg 0.5mm 
15%  25Deg 0.5mm 
10%  25Deg 0.75mm 
25Deg 0.25mm 
5% 
Load at Yield 
0% 
0  200  400  600  800  1000  1200  1400 
Load (N) 
Figure 52: Relative Percent Difference of Redesigned Ratchet FEM Results from
Experimental (Load at yield circled)
The comparison of the experimental data to the theoretical model for the rotated
ratchet samples however, did not demonstrate as strong an agreement. For example, the
relative difference between the theoretical and actual curves for the 25° specimen with
the fillet of .75 mm is 22% at 50 N and 79% at maximum load (Figure 53). The other
specimen geometries exhibited even larger relative differences. The possible cause for
this is discussed further in the next chapter.
95
250.00 
200.00 
Load (N) 
150.00 
100.00  Model r=0.75 
Actual r=0.75 
50.00 
0.00 
0  0.5  1  1.5  2 
Extension (mm) 
Figure 53: Comparison of Rotated Ratchet Theoretical and Experimental Results
CONCLUSION
The two design iterations each for the threaded and ratchet style testing specimens
presented are based on the development of design tools for use in the future inclusion of
such fastening mechanisms in a full socket design. Further discussion of the results
obtained from the analysis and their implications are presented in the following chapter.
96
Chapter 7: Discussion
This study has shown that both threaded and ratchet style fasteners can be
manufactured using SLS. The parts manufactured using SLS were functional and the
theoretical models developed for the fasteners show promise for use in the design of these
fasteners in future adjustable socket designs.
GEOMETRIC ACCURACY
Preliminary SLS builds demonstrated growth issues and were used to determine
minimum feature and clearance sizes. The final iteration of the ratchet and threaded
fastener test specimens show decreased growth and shrinkage as compared to the first
specimen build. However, as the geometric accuracy of the second build of the fastener
testing specimens demonstrated, still further refinement of the solid models is needed to
obtain even tighter dimensional tolerances.
The pitch, minor diameter, and thread thickness of the threaded specimens were
all on average less than 5% different from the nominal dimensions. The thread thickness,
where the greatest discrepancy still resides, decreased from 24% in the first iteration.
This is promising, however, as some of the threaded specimens still varied as much as
10.75% from the nominal dimension, some adjustments to reduce the variability in this
dimension are required.
Similarly, the tooth height and overall length of the ratchet specimens were all
less than 5% different from the nominal size. The tooth thickness, however, still
experienced 28% growth. This contrasts with the initial iteration of the ratchet specimens
where the tooth thickness was on average 30% smaller than the intended size. The rotated
ratchet specimens demonstrated a growth pattern similar to the regular ratchet specimen
design. Again, the tooth height and overall length of the rotated ratchet specimens were
97
less than 5% different from the nominal dimensions. The tooth thickness is again
experiencing greater growth at an average of 13% increase from the intended value. Of
particular note, the second iteration of specimens was able to achieve full tooth length for
all of the specimens as all features were above the minimum feature size, unlike the 1.0
mm tooth thickness ratchet specimens from the first iteration.
Of the dimensions with larger variation from the expected value, those with
smaller thicknesses, such as the tooth and thread thicknesses, are more common. Two
possible reasons for this have been theorized. First, as these features are often only one or
two times the minimum feature size, the SLS manufacturing process could be
experiencing difficulties sintering these smaller features. Second, this could be a result of
the limitations of using calipers to measure the thickness of such small features on a
specimen that is manufactured using a layer based additive manufacturing process. Being
layer based, surface finishes on SLS parts become proportionally less smooth on smaller
feature surfaces as defects take up a greater percentage of the surface area. Therefore
these defects in the surface could be giving false measurement readings.
Impacts of growth and shrinkage varied for the threaded and ratchet fastener
specimens. Due to the reduced growth on the second iteration of the threaded fasteners,
specimen pairs had looser fits. Therefore further optimization of the tooth clearances
could be obtained once stable build results are achieved. For the ratchet specimens, tooth
thicknesses still had growth issues and therefore parts were still not fully contacting along
the crease as designed (Figure 54). This means that the attempt to concentrate load at the
base of the tooth did not occur.
98
Figure 54: Gap in Teeth of Mating Ratchet Specimens
In addition to growth, curl was also encountered in several of the ratchet

specimens from the initial build. Less curl was encountered in the second specimen build.
The exact cause of the decrease in curl is currently unknown though an increase in the
part bed temperature by 1° C and a longer cooling time in the inert build chamber were
implemented in the second build. Curl can be further eliminated with improvement of
build and part parameter setting selection based on whether the curl is occurring during or
after the build process.
Further builds are needed to understand the causes for the differences between
manufactured feature dimensions and the expected nominal dimensions. In addition, curl
was also encountered in several of the ratchet specimens. Curl can be eliminated with
further improvement of build and part parameter setting selection. The impacts of these
growth and shrinkage issues, however, are minimized in the theoretical model by using
the actual dimensions resulting from the build during analysis rather than the nominal
dimensions.
99
LOAD CAPACITY
In spite of the growth issues, both of these fastener test specimen designs
exceeded the load capacity required for their respective applications. The redesigned
threaded specimens sustained a load that exceeded the anticipated load of 2500 N. Some
decrease in the maximum load was anticipated as these specimens were designed to fail
at 3000 N rather than 4000 N as in the first iteration. However, it is questionable whether
the failure of the specimens was in the threads or simply in the tabs. As seen in Figure 55,
the smaller surface area in contact with the grips tended to yield before the threads.
Figure 55: Deformation of Threaded Specimen Pull Tabs
Since the threaded specimens are continuing to yield in the tabs of the samples,
further improvements are needed to strengthen these tabs so that the load is concentrated
on the threads. This will likely require increasing the surface area in contact with the
tensile testing machine clamps. These specimens however are scaled versions of those
that might be included in a height adjustment mechanism. The ability of the threaded
fasteners to withstand 2500 N indicates that smaller pitches can be utilized in a full-scale
application and that an appropriate factor of safety is achievable.
100
As highlighted in Figure 56, some of the load vs. extension curves have an initial
flat section and do not begin to show loading until 0.5 to 0.75 mm extension. This is due
to the fact that the specimens are unloaded at the start of testing and the tensile machine
therefore initially travels without loading the specimen through a distance approximately
equal to the clearance between the threads. A tighter fitting thread or a preload would
therefore reduce this initial unloaded section.
Figure 56: Example of Initial Unloaded Region of Threaded Specimen Load vs.
Extension Curve
For the ratchet fasteners, the average load achieved by all specimens in the second
iteration of the design, 866 N, was higher than the original design, 346 N. This appears to
support the addition of fillets and larger tooth thicknesses for increasing the strength of
the mechanisms. This change is not likely due to the differences in the quality of the
builds obtained as the tensile strength varied from 47.5 to 48.7 MPa and 49.1 to 49.0 MPa
in the two orthogonal directions of the horizontal plane of the build chamber respectively
for the subsequent build. The maximum loads achieved by the final specimen designs
ranged from 9 to 25 times larger than the anticipated load of 47.5 N for the anticipated
101
socket wall implementation. The strength of these ratchet mechanisms therefore implies
that the use of hook style ratcheting fasteners in the full adjustable socket design in a
similar loading condition is feasible.
Upon comparison with trends in other load data, the maximum loading results for
the 1.00 mm tooth thickness from the initial iteration of the ratchet fastener specimens are
suspicious. The tooth did not completely sinter, however, these specimens had the
greatest load capacity. This is likely the result of the load not being concentrated on the
tooth itself but at the base of the tooth. This in turn prompted a redesign of the specimens
such that it helped to concentrate the load at the base of the tooth. To this end, a fillet
with matching radii R was added to the crease as well as the point of the tooth in the
second specimen design iteration.
Due to the design of the tensile testing machine, the maximum loading capacity at
yield of the rotated ratchet specimens, unlike the normal orientation specimens, could not
be measured. This is likely due to looseness of the clamps, which could be displaced as
much as 5 mm horizontally at the point of contact of the testing specimens. With tooth
heights of 3-5 mm, the specimens only maintained contact as long as there was sufficient
friction on the contacting surfaces. Instead, the resistive force due to friction was
measured. Therefore the load results are only indicative of which specimen design, due to
the tooth thickness and angle, had the greatest friction force to resist motion of the
contacting tooth surfaces. Based on these results, the 25° internal tooth angle supported
the greatest load prior to fully disengaging. This suggests the use of smaller angles in the
ratchet specimens for the sake of reducing the potential for unhooking due to a load
direction different from the primary loading orientation. In addition, the larger fillet radii,
and therefore larger tooth thicknesses, also contributed to a greater load before failure.
This is likely due to the increased bending strength of the tooth. These results, however,
102
do not reflect the actual load case that would include an increased normal force, and
therefore friction force, that would be caused by the primary loading orientation acting
simultaneously on the ratchet specimen. The maximum obtained load of 220 N is
therefore an estimate of the force necessary to cause the ratchet to unhook in the weakest
loading condition when there is no load in the orthogonal direction.
MODEL ACCURACY
In addition to the geometric accuracy and load capacity analysis of the fastener
testing specimens, the accuracy of the theoretical models is a final focus of this study.
Due to the failure of some of the threaded specimens in the tabs rather than in the actual
specimen threads, the theoretical model is still not fully verified. Sixty percent of the
tested specimen pairs failed as predicted by the model for the second iteration of
specimens. As all of the specimens sustained a load greater than the 2500 N load
expected in an actual application, these specimens do indicate that smaller pitches can be
utilized in a full-scale application. This model therefore does provide a conservative
estimate of the strength of the threads. Further testing with redesigned tabs for insertion
in the tensile testing machine clamps is needed.
Based on the comparison of the theoretical model results with the experimental
data collected, the ratchet theoretical model is only valid in the linear elastic range. Errors
between the empirical and theoretical results range were less than 10% for most cases in
this region. As this is the target for which a fastener would be designed, using this model
when designing in this region will ensure that there will be a lower occurrence of failure
or yielding of the fastener during use.
103
APPLICATION OF RESULTS
These theoretical models were developed to determine the feasibility of including

fastening mechanisms in a complete adaptable socket design for pediatric patients in
developing countries. As both models have shown promise for this use, several options
for implementation of these fastener designs are possible. The volumetric adjustment
mechanism concepts generated and selected in Chapters 4 and 5 that utilize these fastener
mechanisms therefore can be deemed feasible for implementation in a full socket design.
The most likely use of the threaded fastener is allowing longitudinal height adjustment of
the pylon and its connecting/adjustment mechanism. As described in Chapter 4, the

Threaded Wall longitudinal adjustment concept is a viable implementation of this
fastening mechanism for ensuring the functionality of this volume adjustment concept
(Figure 57).
Figure 57: Possible Threaded Fastener Implementation
Similarly, the ratchet mechanisms designed could be implemented in a radial

adjustment mechanism like the Pipe Clamp concept that would be secured using this
104
ratcheting fastener mechanism (Figure 11). Removal of the ratchet fastener can be aided
by the addition of a release edge that allows the required leverage for the force required
to disengage the latched teeth (Figure 58).
Figure 58: Possible Ratchet Fastener Implementation
As the actual implementation of the fastener mechanisms will likely not take on a
form exactly like those of the testing specimens, the theoretical models developed allow
adjustment of the design to the particular application.
105
Chapter 8: Conclusion
With the great need for properly fitting prosthetic sockets, for pediatric as well as
adult lower limb amputees, this research focused on designing a new prosthetic socket
that addresses a possible solution to this need. Due to the relatively large amount of
volumetric change inherent in children during the natural maturation process, this
research seeks to provide a socket that is adjustable to both the radial and longitudinal
changes in the volume of the residual limb. With an emphasis on transtibial prosthetic
socket designs, a variety of design concepts intended to fulfill the primary functions
identified for an appropriate design were generated. These functions include:
accommodation of both radial and longitudinal volumetric changes in the residual limb,
ability to interface with a socket suspension system and other prosthetic components, user
safety and aesthetics, and methods to combine mechanisms designed for each function
above. Using concept generation techniques modified from those presented by Otto and
Wood (2000), plausible designs were generated and the most promising were selected
based on criteria derived from customer needs analysis consisting of personal experience,
interviews, and reviewing literature. Before a full socket design can be fully realized,
however, a feasibility study of the fastener mechanisms was completed. This feasibility
study was necessary since these mechanisms dictate the overall strength and functionality
of the final socket. Therefore, this research focused on the design and validation of
theoretical models for two fastener mechanisms, the threaded and ratchet style.
Based on design analysis and theoretical models validating the two fastener
mechanisms, the designs are ready for implementation in a final socket design. The
ratchet theoretical model adequately predicts extension based on input loads in the elastic
range of the design curve. The deviation of the theoretical model from the experimental
106
data is less than 10% in this elastic region of the load vs. extension curve. These
specimens continue to sustain loads more than nine times the anticipated load during use.
This therefore suggests that the ratchet fastener model can be confidently applied to the
socket design problem at hand. With this working model, further investigations can be
made into the integrity of the ratchet design in other loading conditions and to determine
whether the fastener will bind under the loads.
The threaded fastener theoretical model has not been fully verified as the
specimens have not consistently yielded in the threads, though they do fail close to the
intended failure load. Those that have failed in the threads, 60% of those tested, did fail
close to the anticipated 3000 N. Further specimen redesigns are needed to fully verify this
theoretical model. However, the threaded specimens that have been manufactured do
provide some information about the strength of threaded fasteners. As they have
sustained the anticipated load at even a scaled size, their implementation in a full
adaptable socket design is feasible. Prediction of their strength via a theoretical model,
however, has not been fully demonstrated, but the model does give a conservative
estimate of where the specimens may fail that can be used in guiding inclusion of these
fastener mechanisms in a socket design. There are possible improvements that can be
made to the threaded specimens to help ensure failure of the threads rather than the tabs.
Increasing the surface area of the tabs in contact with the tensile testing machine clamps
is the first recommended step as the thickness of the tabs is limited by the gap in the
grips.
It would also be of benefit to consider other loading conditions in addition to axial
loading. Axial loading is likely the primary loading condition base on the maximum
loading determined during plyometric jumps (McKay et al., 2005). However, a bending
moment could be experienced at the connection to the socket due to loads being applied
107
sat the toe of the prosthetic foot that would behave as a moment arm. This bending
moment could cause binding of the threads that is not encountered during axial loading
and therefore is an area for further research.
In addition to redesigning the tabs of the threaded testing specimens, the next
steps in this research include refinement of the testing specimens, additional theoretical
models, fatigue analysis, and utilizing the fasteners in combination with the generated
socket concepts to develop a final socket design. As growth was still occurring, though
not greatly impacting the results, in the second iteration of the manufactured testing
specimens, additional optimization of the SLS manufacturing method is needed to hone
the dimensional tolerances of the sintered parts. The ratchet specimens require
optimization of the surface area needed to resist unhooking during slip as well as to help
concentrate load at the base of the tooth where it is thickest. As the rotated ratchet
specimens were not preloaded during testing, a more accurate measure of the force
needed to disengage the hook could be obtained with a preload equal to the tension in the
perpendicular direction. In addition, the theoretical model for the threaded specimens
only accounts for an axial load. As this is only one of the possible loading conditions,
considerations should be made for a bending moment being applied to the load.
Furthermore, fatigue characteristics of these fastening mechanisms remains to be
determined as these specimens were loaded under static conditions until failure and have
not been cycled at the anticipated loads.
Threaded and ratchet style fasteners have been successfully manufactured using
SLS. These specimens, though currently needing further adjustment for growth, are
capable of sustaining loads greater than those expected in their respective applications. In
addition, theoretical models have been presented and preliminary validation has been
provided. As a result of this work, threaded and ratchet style fasteners are shown to be
108
feasible methods for incorporating radial and longitudinal volumetric change methods
into a single volume compensation socket design for pediatric patients in developing
countries.
109
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115
Vita
Meagan R. Vaughan hails from Ovilla, Texas where she was homeschooled by
her parents. During late high school and the following year, she attended Cedar Valley
Community College, Lancaster, Texas, where she received an Associate of Science
degree in May 2004. The following fall found her in attendance at LeTourneau
University, Longview, Texas, where she completed a Bachelor of Science in Engineering
with a concentration in Mechanical Engineering in May 2007. During her time at
LeTourneau University, Meagan was an active participant for two years in the
LeTourneau Engineering Global Solutions (LEGS), now LeTourneau Empowering
Global Solutions, program designing low-cost lower limb prosthetic components for
developing countries. With this experience, she entered the University of Texas at Austin
in September 2007, to pursue additional education and further research in designing
lower limb prosthetic components.
Email Address: [email protected]

This thesis was typed by Meagan R. Vaughan.
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Design and Analysis of a Volume Adjustable Transtibial Prosthetic

Meagan Renee Vaughan, BS

Master of Science in Engineering

The University of Texas at Austin

Design and Analysis of a Volume Adjustable Transtibial Prosthetic

Meagan Renee Vaughan, MSE

Supervisor: Richard H. Crawford

For pediatric amputees in developing countries, where characteristically rapid

Chapter 2: Background ...........................................................................................3

Chapter 3: Proposed Solution Requirements ........................................................21

Chapter 4: Design Solution Concept Generation..................................................32

Chapter 5: Concept Selection................................................................................52

Chapter 6: Design Embodiment and Verification Results.....................................62

Chapter 7: Discussion ...........................................................................................97

Proper design of a prosthetic socket component is critically important to an

Limb amputation can be a life-altering event that requires special attention.

Table 1: Causes of Amputation for Developed and Developing countries (Dillingham et

1. Description of Prosthetic Limb

As a unit, the primary function of an artificial limb is to replace the motor

2. Evolution of Prosthesis Design

3. State of the Art

More contemporary designs use modern engineering materials and manufacturing

PTB-SC Socket. Fig 3. Supracondylar socket.

tunately, the contours of the anteromedial

GENERAL CASE NEEDS

In spite of the advancements made in understanding socket fit and improving

2. Impact of Poor Fit

3. Existing Solutions for Volume Compensation

As adults have stopped growing longitudinally, most volumetric change

4. Shortfalls of Existing Technologies

Unfortunately, due to the lack of resources, technology available in developing

Selective Laser Sintering is an Additive Manufacturing technology that was first

Building on the traditional use of CAD/CAM to produce a prosthetic socket,

The Squirt Shape Prosthetic Socket developed at Northwestern University

A successfully designed volume-compensating socket has the potential to

Chapter 3: Proposed Solution Requirements

SOURCES FOR CUSTOMER NEEDS ANALYSIS

Designing a transtibial prosthetic socket manufactured using SLS for

This program provided general knowledge of available prosthetic technology,

Table 2: Specification Sheet

BIOMEDICAL AND BIOMECHANICAL REQUIREMENTS

In designing a prosthetic socket for use in developing countries, special

Figure 6: Comparison of Additive Manufacturing Processes to Tensile Strength (Kim &

As the focus of this thesis is limited to the design of volume compensation

In addition to manufacturing, biomedical and biomechanical, adjustability, and

Figure 7: Pyramid Style Adapter Components (Ossur, 2009)

CONCEPT GENERATION METHODS

In Design by Analogy, design solutions for products that perform analogous

Figure 8: Pipe Clamp Example (www.McMaster.com)

Sliding Door Cabinet Lock by Kidco, Inc.

Door Knob Lock by Kidco, Inc.

Adjustable Latch by Kidco, inc.

Child Resistant Pill Bottle Cap

Hasbro Playskool's Sesame Street Busy Poppin' Pals

Table 3: Analogies Considered for Actuation Mechanisms Pertaining to Children

Walmart Razor A Kick Scooter

Century Novelty Finger Trap

Table 3: Analogies Considered for Actuation Mechanisms Pertaining to Children (cont.)

An additional method used to generate possible solutions was through the

Chapter 2: Background ...........................................................................................3 

Chapter 3: Proposed Solution Requirements ........................................................21 

Chapter 4: Design Solution Concept Generation..................................................32 

Chapter 5: Concept Selection................................................................................52 

Chapter 6: Design Embodiment and Verification Results.....................................62 

Chapter 7: Discussion ...........................................................................................97 

Table 6: Radial Change Elimination Matrix 

Table 8: Longitudinal Change Elimination Matrix 

Table 9: Fastener Selection Criteria and Ranking Scale 

Table 10: Fastener Elimination Matrix 

Table 12: Socket Interface Elimination Matrix 