Current transfemoral sockets.
Clinicians have two types of prosthetic sockets for patients with a transfemoral amputation: the quadrilateral socket introduced in the 1950s and the ischial containment socket introduced in the 1980s. For many years, the quadrilateral socket was acceptable to clinicians and patients alike. With the introduction of the ischial containment socket claims were made that the quadrilateral socket had been inadequate from its inception. It also was claimed that the ischial containment design was the answer to all problems than patients with transfemoral amputations may have. Unfortunately, there is only one scientific study that lends any support to claims of the ischial containment socket's superiority and its findings are limited. Still, clinicians must make recommendation and prescription decisions daily regarding what is best for their patients. There are two acceptable socket designs for patients with transfemoral amputations. Experience with both supports the concept that they have more similarities than differences and that each has a legitimate place in the treatment of patients with transfemoral amputations. A comprehensive understanding of each socket design and its biomechanical intentions is essential for successful clinical application and treatment of patients with amputations.