[0001] TECHNICAL FIELD

[0002] The disclosure relates to an adjustable socket system for a residual limb.

[0003] BACKGROUND

[0004] A typical prosthetic leg and foot include a socket, pylon, and foot. A socket is commonly referred to as the portion of a prosthesis that fits around and envelops a residual limb or stump, and to which prosthetic components, such as a foot, are attached. Fitting and alignment of the socket are difficult tasks to perform, and require extensive knowledge, training and skill for the prosthetist.

[0005] The socket must fit closely to the stump to provide a firm connection and support, but must also be sufficiently loose to allow for circulation. In combination with proper fitting, the socket must transfer loads from the residual limb to the ground in a comfortable manner.

[0006] Conventional sockets are rigid and generally have a general uniform shape which receives a large portion of the residual limb. These sockets are permanently formed to a customized shape that is static, meaning the socket does not account for shape and volume fluctuations of the residual limb. When there are shape and volume fluctuations, the fitting of the socket is impeded, with these sockets causing discomfort, pain and soft tissue breakdown of the stump. Conventional sockets also tend to be bulky and cumbersome to wear, and may be difficult to don, making the residual limb uncomfortable when worn.

[0007] Some attempts have been made to develop adjustable sockets with individual components that can be varied to account for volume and shape fluctuations of the residual limb. Such sockets, however, tend to have poor force distribution on the residual limb, causing a concentration of pressure on certain areas of the residual limb. This poor distribution of pressures causes pain, discomfort, and even tissue breakdown. Such sockets also tend to provide unsatisfactory support and suspension. They also can necessitate massive inventories of components, increasing expense and space requirements.

[0008] SUMMARY

[0009] Conventional sockets are known to inadequately account for shape and volume fluctuations of a residual limb. They also tend to be bulky and cumbersome to wear. Known adjustable socket systems may better accommodate shape and volume fluctuations than conventional sockets but tend to be uncomfortable and provide inadequate support and suspension. There is thus a need for an adjustable socket that can both comfortably accommodate shape and volume fluctuations of the residual limb, and provide improved support and stability.

[0010] Embodiments of the present disclosure comprise an adjustable socket system that provides superior structure adjustment features over prior art adjustable socket systems. From its versatility in fitting and force distribution, the adjustable socket system can decrease discomfort and improve support and stability over known adjustable sockets. Moreover, it will be appreciated that the adjustable socket systems of the present disclosure may be adapted to a variety of different types of amputations, whether configured for the leg or arm.

[0011] The adjustable socket system of the present disclosure can include a base, longitudinal supports connected to the base and extending along a longitudinal axis, and shell components operatively connected to the longitudinal supports and defining a receiving volume adapted to receive a residual limb. The adjustable socket system is movable between an open configuration in which at least one of the shell components is moved radially outward relative to the longitudinal axis to loosen the fit of the adjustable socket system, and a closed configuration in which at least one of the shell components is moved radially inward relative to the open configuration to secure the fit of the adjustable socket system on the residual limb.

[0012] The shell components include a first shell component having distal and proximal parts that are longitudinally displaceable with respect to one another such that a length of the first shell component is adjustable between a first length, and a second length different than the first length. By adjusting the relative longitudinal positions between the distal and proximal parts, the shell components can better accommodate residual limbs of different lengths. It also advantageously improves the fit, stability, and support provided by the system over prior art adjustable socket systems.

[0013] According to a variation, an overlap is defined between the proximal and distal parts along the longitudinal axis. As the overlap between the distal and proximal parts varies the contact surface between the first shell component and the residual limb varies. This allows the contact surface area of the first shell component to structurally or physically adapt to the length of the residual limb, improving the force distribution and fit of the adjustable socket system. [0014] This is advantageous over prior art systems including supports that simply reposition the same contact area at different heights using adjustable struts, providing inadequate force distribution and stability. The adjustable length of the shell component is also beneficial because it does not require a large inventory of parts that have to be interchanged to fit and support different lengths of the residual limbs as in the prior art.

[0015] BRIEF DESCRIPTION OF THE DRAWINGS

[0016] These and other features, aspects, and advantages of the present disclosure will become better understood regarding the following description, appended claims, and accompanying drawings.

[0017] Fig. 1 is a side view of an adjustable socket system according to an embodiment.

[0018] Fig. 2 is a top view of the adjustable socket system in Fig. 1.

[0019] Fig. 3 A is a side view of the adjustable socket system in Fig. 1.

[0020] Fig. 3B is another side view of the adjustable socket system in Fig. 1.

[0021] Fig. 4A is a perspective view of a longitudinal support according to an embodiment.

[0022] Fig. 4B is a cross section of the longitudinal support shown in Fig. 4A.

[0023] Fig. 5 is an exploded view of a shell component according to an embodiment.

[0024] Fig. 6 is a perspective view of the distal part of the shell component in Fig. 5.

[0025] Fig. 7 is a side view of another shell component according to an embodiment.

[0026] Fig. 8 is a cross section of a shell component according to another embodiment.

[0027] Fig. 9 is an exploded view of a longitudinal support and base according to an embodiment.

[0028] Fig. 10 is an assembled view of the longitudinal support and base in Fig. 9.

[0029] Fig. 11 is a bottom view of a base according to another embodiment.

[0030] Fig. 12 is a bottom view of a base according to another embodiment.

[0031] Fig. 13 is a cross section of a longitudinal support and base according to another embodiment. [0032] Fig. 14A is a perspective view of a base according to another embodiment.

[0033] Fig. 14B is a bottom view of the base of Fig. 14 A.

[0034] Fig. 15A is a side view of a distal insert according to an embodiment.

[0035] Fig. 15B is a side view of the distal insert of Fig. 15A inserted in an adjustable socket system.

[0036] Fig. 16 is a side view of an adjustable socket system according to another embodiment.

[0037] Fig. 17 is a side view of an adjustable socket system according to another embodiment.

[0038] Fig. 18 is a front view of an adjustable socket system according to another embodiment.

[0039] Fig. 19 is a front view of an adjustable socket system according to another embodiment.

[0040] Fig. 20A is a side view of a shell component in a first predetermined length according to another embodiment of an adjustable socket system.

[0041] Fig. 20B is a side view of the adjustable socket system of Fig. 21 A in a second predetermined length.

[0042] Fig. 21 A is a side view of an adjustable socket system in a second predetermined length according to another embodiment.

[0043] Fig. 21B is a side view of the adjustable socket system of Fig. 21 A in a first predetermined length.

[0044] Fig. 22A is a side view of an adjustable socket system according to another embodiment.

[0045] Fig. 22B is a detailed view of the adjustable socket system of Fig. 22 A.

[0046] Fig. 23 A is a side view of an adjustable socket system according to another embodiment.

[0047] Fig. 23B is a detailed view of the adjustable socket system in Fig. 23 A.

[0048] Fig. 23 C is a detailed side view of the adjustable socket system of Fig. 23 A.

[0049] Fig. 24 is a side view of an adjustable socket system according to another embodiment.

[0050] Fig. 25 is a side view of an adjustable socket system according to another embodiment. [0051] Fig. 26 is a side view of an adjustable socket system according to another embodiment.

[0052] DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS

[0053] A better understanding of different embodiments of the disclosure may be had from the following description read with the accompanying drawings in which like reference characters refer to like elements.

[0054] While the disclosure is susceptible to various modifications and alternative constructions, certain illustrative embodiments are in the drawings and are described below. It should be understood, however, there is no intention to limit the disclosure to the specific embodiments disclosed, but on the contrary, the intention covers all modifications, alternative constructions, combinations, and equivalents falling within the spirit and scope of the disclosure.

[0055] Figs. 1 and 2 illustrate an adjustable socket system 100 according to an embodiment including a base 102, a plurality of longitudinal supports 104 connected to the base 102, and a plurality of shell components 106 connected to the longitudinal supports 104. The shell components 106 collectively form a socket wall 108 defining a receiving volume 110 adapted to receive a residual limb. The base 102 is arranged to provide support for a distal end of the residual limb and can include at least one coupling device 112 (shown in Fig. 2) for fixing or securing the residual limb or a liner to the base 102. The longitudinal supports 104 are shown comprising elongate medial and lateral supports 104 A, 104B, but can be in any suitable configuration.

[0056] The adjustable socket system 100 is radially adjustable between an open configuration and a closed configuration. In the open configuration, at least some of the longitudinal supports 104 and/or shell components 106 are free to move or are forced radially outward relative to a longitudinal axis 116 of the adjustable socket system 100, increasing the receiving volume 110 or increasing a circumference of the adjustable socket system 100. This effectively loosens the fit of the adjustable socket system 100 on a residual limb inserted in the receiving volume 110, or decreases the loading on the residual limb from the socket wall 108.

[0057] In the closed configuration, at least some of the longitudinal supports 104 and/or the shell components 106 are moved or forced radially inward relative to the open configuration, decreasing the receiving volume 110 or decreasing the circumference of the adjustable socket system 100. For instance, the longitudinal supports 104 can comprise a medial support 104A having an elongate configuration and a lateral support 104B having an elongate configuration.

[0058] At least one of the medial or lateral supports 104A, 104B can be pivotally connected to the base 102 such that in the closed configuration at least one of the supports 104 A, 104B is folded or rotated toward the other to decrease the receiving volume 110. This tightens the fit of the adjustable socket system 100 on a residual limb inserted in the receiving volume 110 and/or increases the loading on the residual limb from the socket wall 108. It will be appreciated that movement of any portion of a longitudinal support 104 or shell component 106 can move the adjustable socket system 100 between the open and closed configurations. In other embodiments, at least one of the longitudinal supports 104 has a non-articulating configuration adapted to bend or flex in order to adjust or vary the receiving volume 110.

[0059] A tightening system 114 is arranged to move the adjustable socket system 100 between the open and closed configurations. The tightening system 114 includes at least one tensioning element 118, a plurality of guides 119 accommodating and directing the at least one tensioning element 118, and a tensioning unit 121 operatively linked to the at least one tensioning element 118. When the tensioning unit 121 is moved to an on position, a corresponding tensioning element 118 is longitudinally displaced, increasing tension in the at least one tensioning element 118. This causes at least the lateral support 104B and/or the shell components 106 to move toward the closed configuration, tightening or securing the fit of the adjustable socket system 100 on the residual limb. When the tensioning unit 121 is moved to an off position, the at least one tensioning element 118 can return toward its original position, decreasing tension in the tensioning element 118. This allows the longitudinal supports 104 and/or the shell components 106 to move toward the open configuration, loosening the fit of the adjustable socket system 100.

[0060] The shell component 106 can include a first shell component 122 that wraps around and engages at least a medial aspect of the residual limb and a second shell component 120 that wraps around and engages at least a lateral aspect of the residual limb. The first and second shell components 122, 120 can be configured differently. The first shell component 122 can extend or wrap around a substantial portion of the circumference of the adjustable socket system 100.

[0061] The second shell component 120 can wrap from a lateral side to a medial side, terminating at a medial or trailing edge 124. The first shell component 122 can wrap from a medial side to a lateral side, terminating at a lateral or leading edge 126. According to a variation, an upper edge of the first shell component 122 can extend upwardly toward the leading edge 126 such that a reduced height of the first shell component 122 is formed along the medial aspect of the residual limb. This beneficially improves comfort by reducing the likelihood of interference between the first shell component 122 and a user's unaffected limb and/or other body part.

[0062] As seen in Fig. 2, the first and second shell components 122, 120 overlap one another in a circumferential direction in at least the closed configuration. In an embodiment, a portion of an inner surface of the first shell component 122 can overlap a portion of an outer surface of the second shell component 120 to form a circumferential overlap between the trailing and leading edges 124, 126. As the adjustable socket system 100 moves between the closed and open configurations, the circumferential overlap between the first and second shell components 122, 120 varies, which, in turn, beneficially permits volume adjustment within a volume range. The circumferential overlap also permits improved pressure distribution from the adjustable socket system 100 onto the residual limb during use and thus a better fit. This reduces the likelihood of soft tissue from bulging out or escaping out of the adjustable socket system 100, increasing user comfort.

[0063] Referring now to Figs. 3A and 3B, at least one of the shell components 106 has an adjustable height, improving the fit, stability, and support provided by the adjustable socket system 100 over prior art adjustable socket systems. For instance, the first shell component 122 can include a distal part 130 and a proximal part 132 that are arranged to be longitudinally displaceable with respect to one another, so that they can be adjusted and fixed in relation to one another either continuously or in a step-adjustable manner. By adjusting the relative longitudinal position between the distal and proximal parts 130, 132, a change of length of the first shell component 122 can be achieved in order to better accommodate residual limbs of different lengths.

[0064] A reduction of a length of the first shell component 122 can be achieved by moving the proximal part 132 toward the distal part 130 along the medial support 104A as shown in Fig. 3A. An increase of the length of the first shell component 122 can be achieved by moving the proximal part 132 away from the distal part 130 along the medial support 104 A as shown in Fig. 3B. Adjusting the relative longitudinal position between distal and proximal parts 130, 132 can thus adjust the length of the first shell component 122 between a first predetermined length LI (shown in Fig. 3A) and a second predetermined length L2 (shown in Fig. 3B). It also allows the adjustable socket system 100 to accommodate longitudinal supports 104 of different heights or lengths. It can also adapt or adjust the desired load on the residual limb.

[0065] As seen, the distal part 130 and the proximal part 132 overlap one another in a longitudinal direction, defining an overlap between a proximal end 136 (shown in Fig. 5) of the distal part 130 and a distal end 138 (shown in Fig. 5) of the proximal part 132. This longitudinal overlap helps ensure that there are no or minimal longitudinal gaps between the distal part 130 and the proximal part 132 as the first shell component 122 supports a residual limb during use.

[0066] The size of the overlap increases as the proximal part 132 moves toward the distal part 130 along the medial support 104 A, which, in turn, shortens the length of the first shell component 122 and moves it toward the first predetermined length LI . The length or size of the overlap decreases as the proximal part 132 moves away from the distal part 130 along the medial support 104 A, which, in turn, increases the length of the first shell component 122 and moves it toward the second predetermined length L2.

[0067] As the overlap between the distal and proximal parts 130, 132 varies, the contact surface area between the first shell component 122 and the residual limb varies. For example, the first shell component 122 can continuously engage and support the residual limb between the first and second predetermined lengths LI, L2. As the overlap decreases, the contact surface between the first shell component 122 and the residual limb increases. As the overlap increases, the contact surface between the first shell component 122 and the residual limb decreases. This advantageously allows the contact surface area of the first shell component 122 to physically and structurally adapt to the length of the residual limb, improving the force distribution and fit of the adjustable socket system 100. If a user's residual limb is taller or longer, the length and contact surface of the first shell component 122 can be lengthened or increased by sliding the proximal part 132 away from the distal part 130 along the medial support 104 A to account for the greater length. If a user's residual limb is shorter, the length and contact surface area of the first shell component 122 can be shortened or decreased by sliding the proximal part 132 toward the distal part 130 along the medial support 104 A to account for the shorter length.

[0068] This is advantageous over prior art systems including supports that simply reposition the same contact area at different heights using adjustable struts, providing inadequate force distribution and stability. The adjustable length of the first shell component 122 is also beneficial because it does not require a large inventory of parts that have to be interchanged to fit and support different lengths of the residual limbs as in the prior art.

[0069] It will be appreciated that the distal and proximal parts 130, 132 of the first shell component 122 can be operatively connected to one another in any suitable manner. For instance, the proximal part 132 can be slidably attached to the medial support 104A via an elongate slot 134. In an embodiment, the distal part 130 is attached to the medial support 104 A via a plurality of fasteners 140 and medial support 104A defines the elongate slot 134. A stiffening member 142 on the proximal support 132 is attached to the medial support 104A via a plurality of fasteners 144 extending through the elongate slot 134, which, in turn, slidably attach the proximal part 132 to the medial support 104A. This sliding attachment allows for continuous adjustment of the longitudinal position of the proximal part 132 relative to the distal part 130 along the length of the elongate slot 134. The length of the elongate slot 134 can in part define the first and second predetermined lengths LI, L2 of the first shell component 122.

[0070] In use, the fasteners 144 can be manipulated to selectively lock and unlock the longitudinal position of the proximal part 132 relative to the distal part 130. To fix or lock the longitudinal position of the proximal part 132 relative to the distal part 130, the fasteners 144 can be tightened to clamp the stiffening member 142 to the medial support 104A. To adjust the longitudinal position of the proximal part 132 relative to the distal part 130, the fasteners 144 can be loosened to unclamp the stiffening member 142 from the medial support 104 A, which, in turn, allows the proximal part 132 to slide up and down within the elongate slot 134. This beneficially permits the length of the first shell component 122 to adjust between the first and second predetermined lengths LI, L2, better accommodating residual limbs of different lengths.

[0071] The outer surface of the proximal part 132 is shown slidably engaging the inner surface of the distal part 130 however in other embodiments the inner surface of the proximal part 132 can slidably engage the outer surface of the distal part 130 as the first shell component 122 adjusts in length.

[0072] Figs. 4A and 4B illustrate an alternative connection between the distal and proximal parts 130, 132 according to another embodiment. Similar to the previous embodiment, the distal part 130 is attached to the medial support 104 A and the proximal part 132 is attached to a stiffening member 142 A. A clamping plate 146 is attached to the medial support 104 A via a plurality of fasteners 148 and to the stiffening member 142A via protrusions 150 of the clamping plate 146 slidably located within corresponding guides or tracks 152 formed on the stiffening member 142 A. The clamping plate 146 and the stiffening member 142 A are located within a recess 154 defined along a posterior aspect of the medial support 104 A.

[0073] In use, the fasteners 148 can be manipulated to selectively lock and unlock the longitudinal position of the stiffening member 142A (and proximal part 132) relative to the medial support 104A (and distal part 130). To fix or lock the longitudinal position of the proximal part 132 relative to the distal part 130, the fasteners 148 can be tightened to clamp the stiffening member 142 A between the clamping plate 146 and the medial support 104 A. To adjust the longitudinal position of the proximal part 132 relative to the distal part 130, the fasteners 148 can be loosened to unclamp the stiffening member 142 A from the medial support 104 A, allowing the proximal part 132 to slide up and down within the tracks 152.

[0074] Figs. 5 and 6 illustrate the first shell component 122 in additional detail. The first shell component 122 includes the distal part 130 and the proximal part 132 arranged to overlap one another in a longitudinal direction. The overlap between the distal and proximal parts 130, 132 is generally defined between the proximal end 136 of the distal part 130 and the distal end 138 of the proximal part 132.

[0075] A shoulder or abutment 154 is defined along the outer surface of the proximal part 132. The shoulder 154 can extend in a transverse direction across the proximal part 132. The proximal part 132 can move toward the distal part 130 until the proximal end 136 of the distal part 130 reaches or substantially reaches the shoulder 154. The shoulder 154 can thus provide a stop or limit to longitudinal movement between the distal and proximal parts 130, 132 in a direction toward the first predetermined length LI (shown in Fig. 3A). It can also offer an index or indicator so that a user or clinician adjusting the height or length of the first shell component 122 can tell whether the first shell component 122 has been fully moved to the first predetermined length LI .

[0076] The distal and proximal parts 130, 132 can be contoured to generally correspond to the residual limb and can have a flexibility to bend and shape to the residual limb and a stiffness to distribute forces from the tightening system 114 and create stability in the adjustable socket system 100. Exemplary suitable materials for forming the distal and proximal parts 130, 132 can include plastic materials, such as thermoplastic or thermosetting polymers, fiber reinforced plastic, polypropylene, polyethylene, molded chopped fibers, or any other suitable materials. In an embodiment, the material forming the distal and proximal parts 130, 132 can include antimicrobial and/or ultraviolet protection additives.

[0077] As seen, the proximal part 132 includes a flexible edge 156 on the proximal aspect. The flexible edge 156 is arranged to bend or flex when the user's residual limb exerts a force on the flexible edge 156. This has the effect of reducing the likelihood of creating a pressure point on the residual limb from the proximal part 132 and can provide pressure relief to the residual limb, improving the comfort and effectiveness of the adjustable socket system 100. The flexible edge 156 can extend along some or all of a width of the proximal aspect. Optionally, an end section 156A can angle, curve, or extend away from the other portions of the flexible edge 156 or the residual limb, spacing the end section 156A a distance away from the residual limb. Because the end section 156 A extends away from the residual limb, the residual limb can bend or flex the flexible edge 156 further away from the proximal part 132 as the residual limb pushes against the flexible edge 156, reducing pressure points or edge pressures on the residual limb from the proximal part 132.

[0078] The flexible edge 156 can be formed via overmolding a different material onto the proximal aspect of the proximal part 132. For instance, the flexible edge 156 can be formed via a flexible plastic or elastomer, such as, for example, thermoplastic elastomer (TPE) or other suitable material. In other embodiments, the flexible edge 156 can be formed by a thinner portion of the proximal part 132. In other embodiments, the flexible edge 156 can be removably attached to the proximal part 132 so that it can be easily removed for replacement and/or cleaning. This can improve versatility of the adjustable socket system 100 and/or user hygiene. For instance, the flexible edge 156 can be selected from an inventory of flexible edge components having a range durometers so that the flexible edge 156 can be selected and attached to the proximal part 132 based on user preference, activity, and/or other criteria.

[0079] According to a variation, the proximal part 132 includes an interface region 158 along an inner surface of the proximal part 132. The interface region 158 can include one or more materials with a high coefficient of friction such as elastomeric polymers to increase friction or suspension between the proximal part 132 and the residual limb. The interaction between the interface region 158 and the residual limb can help control transverse rotation, pistoning, or other unwanted movement between the proximal part 132 and the residual limb. The interface region 158 can also provide additional cushioning to the residual limb, improving user comfort. In an embodiment, the interface region 158 is overmolded on the proximal part 132 over a plurality of apertures 160 in the proximal part 132, mechanically fastening the interface region 158 to the proximal part 132. In an embodiment, the material forming the flexible edge 156 (e.g., TPE) can extend distally a distance along an inner surface of the proximal part 132 to form the interface region 158.

[0080] An outer surface of the proximal part 132 defines a receptacle 162 extending in a longitudinal direction for the medial support 104 A. The receptacle 162 can be arranged to generally correspond to the configuration of the medial support 104 A.

[0081] The stiffening member 142 is shown attached to the proximal part 132 within the receptacle 162 and extending in a longitudinal direction along the outer surface of the proximal part 132. The stiffening member 142 can be over-molded on the proximal part 132 or attached in any other suitable manner. The stiffening member 142 and the proximal part 132 can have a same length or a different length. The stiffening member 142 can extend between the distal end 138 of the proximal part 132 and a closed end of a receptacle 162. The stiffening member 142 can be formed of metal, aluminum, plastic, carbon fiber, combinations thereof, or any other suitable material.

[0082] A plurality of guides 164 are located on the outer surface of the proximal part 132 at or near the leading edge 126 of the first shell component 122. The guides 164 can be integral to the proximal part 132, lowing the overall profile of the adjustable socket system 100. The guides 164 are shown having an elongate or c- shape that directs a tensioning element 118 along a length of the leading edge 126.

[0083] Referring now to the distal part 130, its outer surface includes a receptacle 166 for the medial support 104 A and a plurality of guides 168 for tensioning elements 118 of the tightening system 114 at or near the leading edge 126. As seen, the guides 168 can extend along substantially the entire height or length of the proximal part 132, which, in turn, helps the tensioning elements 118 more evenly tension the shell components 106. A plurality of fastener holes 170 are arranged for receiving fasteners 140 to attach the distal part 130 to the medial support 104 A. Optionally, a cutout 172 is formed in the proximal edge 136 between the fastener holes 170.

[0084] Referring to Fig. 6, a lip 174 extends radially inward and circumferentially from a distal aspect of the distal part 130. The lip 174 is arranged to be compressed against the residual limb when the adjustable socket system 100 is donned. This helps the adjustable socket system 100 better conform to the residual limb and minimizes movement of the adjustable socket system 100 relative to the residual limb during use. The lip 174 can be formed via a flexible plastic or elastomer, such as, for example, thermoplastic elastomer (TPE) or other suitable material.

[0085] According to a variation, the inner surface of the distal part 130 can include one or more features to help control transverse rotation, pistoning, or other unwanted movement between the distal part 130 and the residual limb. For instance, the inner surface of the distal part 130 can include cuts 177, crushable ribs, or bosses.

[0086] Fig. 7 illustrates the second shell component 120 according to an embodiment. The second shell component 120 includes a distal part 176 and a proximal part 178 attached to the lateral support 104B. The distal and proximal parts 176, 178 overlap one another and are arranged to be longitudinally displaceable with respect to one another, similar to the distal and proximal parts 130, 132 of the first shell component 122. The outer surface of the proximal part 178 is shown slidably engaging the inner surface of the distal part 176; however, in other embodiments the inner surface of the proximal part 178 can slidably engage the outer surface of the distal part 176.

[0087] Similar to the first shell component 122, the proximal part 178 of the second shell component 120 can slide along the lateral support 104B (shown in Fig. 1) to longitudinally displace the proximal part 178 relative to the distal part 176. In other embodiments, the proximal part 178 to be repositioned relative to the distal part 176 by lengthening and shortening the lateral support 104B.

[0088] The distal and proximal parts 176, 178 can be contoured to generally correspond to the residual limb and can have a flexibility to bend and shape to the residual limb, and a stiffness to distribute forces from the tightening system 114 and create stability in the adjustable socket system 100. The distal and proximal parts 176, 178 can be made of the same materials as the first shell component 122. As seen, the second shell component 120 has a greater length than the first shell component 122.

[0089] The proximal part 178 can include an interface region 180 arranged to form an interface between the residual limb and the proximal part 178. The interface region 180 can be located along a proximal region of the proximal part 178 and formed of TPE or other suitable material. One or more bosses 182 can be arranged on the inner surface of the proximal part 178 to help control transverse motion, pistoning, and/or other unwanted motion between the proximal part 178 and the residual limb. The bosses 182 are shown within the interface region 180 but can be located on any suitable portion of the proximal part 178. According to a variation, the distal and proximal parts 176, 178 define a plurality of elongate slots 184 to help provide transverse motion control and ventilation.

[0090] According to a variation, a shoulder or abutment 186 can be defined along the inner surface of the distal part 176. The shoulder 186 can extend in a transverse direction across the distal part 176. The proximal part 178 can move toward the distal part 176 until a distal end 188 of the proximal part 178 reaches or substantially reaches the shoulder 186, providing a stop or index for a user or clinician.

[0091] Fig. 8 is a cross section of a shell component 106 according to an embodiment. The shell component 106 can include an inner layer 190, an outer layer 192, and a semi-rigid or rigid body 194 between the inner and outer layers 190 and 192. The inner layer 190 can define an inner surface of the shell component 106. The inner layer 190 can include a rubber or elastomer material. The inner layer 190 can be a textile layer and can be skin friendly. The inner layer 190 can include padding or cushioning material to increase user comfort. The outer layer 192 can define an outer surface of the shell component 106. The outer layer 192 can comprise a robust or durable material. The outer layer 192 can comprise a fabric or textile material arranged to form an anchor for the guides and to resist failure under tension from the tensioning elements.

[0092] The inner and outer layers 190, 192 can comprise a textile sleeve 196 defining a pocket arranged to receive the body 194. The body 194 can be repeatedly removable from the sleeve 196. This advantageously can allow the body 194 to be removed from the sleeve 196 such that the sleeve 196 can be washed and/or repaired. The body 194 can be attached to the sleeve 196 via adhesives, magnets, hook and loop systems, or any other suitable method.

[0093] Fig. 9 shows the base 102 and a longitudinal support 104 in an exploded configuration and Fig. 10 shows the base 102 and longitudinal supports 104 in an assembled configuration. The base 102 can have a concave shape or any other suitable shape for supporting a distal end of a residual limb.

[0094] The longitudinal supports 104 are removably attached to the base 102 via one or more fasteners 111. As discussed above, at least one of the longitudinal supports 104 can flex or bend relative to the base 102 or it can be attached to the base 102 in a pivoting or folding manner. The base 102 and longitudinal supports 104 can be formed of any suitable material. For example, the base 102 and/or distal end portions 105 of the longitudinal supports 104 can comprise molded parts including plastic with carbon fiber mixed therein. This beneficially reduces the weight and cost of the adjustable socket system 100.

[0095] The angle of at least one of the longitudinal supports 104 relative to the longitudinal axis 116 can be adjustable via the connection between the longitudinal support 104 and the base 102. The upper surface of the base 102 defines at least one seat 107 arranged to generally correspond to the configuration of the distal end portion 105 of the longitudinal support 104. Particularly, the seat 107 defines a curvature generally corresponding to a curvature of an outer surface of the distal end portion 105, such that as the distal end portion 105 is moved distally along the seat 107, an angle S between a proximal portion 109 of the longitudinal support 104 and the longitudinal axis 116 increases. As the distal end portion 105 is moved proximally along the seat 107, the angle S decreases. The angle of the longitudinal support 104 relative to the longitudinal axis 116 is thus adjustable by adjusting the position of the distal end portion 105 along the seat 107. The curvature and/or length of the seat 107 can define in part a range of angular adjustment for the longitudinal support 104. [0096] The distal end portion 105 can be attachable to the base 102 via a pair of fasteners 111 extending through a pair of through-holes 113 in the base 102 and a pair of elongated through-holes 115 in the distal end portion 105 of the support 104. The elongated through-holes 115 beneficially enable a continuous adjustment of the position of the distal end portion 105 relative to the base 102 along the length of the through-hole 115.

[0097] The fasteners 111 can be manipulated to selectively lock and unlock the angular position of the distal end portion 105 of the longitudinal support 104 relative to the longitudinal axis 116. To fix or lock the angular position of the distal end portion 105 of the longitudinal support 104 relative to the longitudinal axis 116, the fasteners 111 can be tightened to clamp the distal end portion 105 between the upper surface of the base 102 and a clamping plate 117. The clamping plate 117 includes a pair of holes arranged to receive the fasteners 111. To adjust the angular position of the distal end portion 105 of the longitudinal support 104 relative to the longitudinal axis 116, the fasteners 111 can be loosened to unclamp the distal end portion 105 between the base 102 and the clamping plate 117, which, in turn, allows the distal end portion 105 to move along the seat 107.

[0098] The base 102 and/or distal end portion 105 can include one or more indicators 151 that communicate to a user or clinician what angle S the longitudinal support 104 is at. This permits the clinician to objectively know the current angulation of the longitudinal support 104 and/or keep a record if desired. If subsequent changes are made, the clinician can track the changes and effects over time.

[0099] Optionally, the seat 107 defines a protrusion 121 arranged to interact with a corresponding groove on an outer surface of the distal end portion 105 of the longitudinal support 104. When the distal end portion 105 is attached to the base 102, the interaction between the protrusion 121 and the corresponding groove help prevents the distal end portion 105 from rotating on the base 102 around the fasteners 111, enhancing rotational stability.

[00100] An adaptor 101 is attachable to a bottom surface of the base 102. The adaptor 101 is adapted to be attached to a prosthetic limb such as a prosthetic pylon or foot and is made from a substantially rigid material to support the weight or load placed on the prosthetic limb. The adaptor 101 is shown as a female adaptor but can be a male adaptor or any other suitable attachment adaptors.

[00101] With reference to Figs. 11 - 14, alternative embodiments of the base shown in Figs. 1 - 10 are illustrated. The alternative bases may be arranged to adjust the alignment and/or circumference of the adjustable socket system 100. Fig. 11 illustrates a base 202 including a bottom surface defining a plurality of attachment holes 203 for connecting a prosthetic adaptor 201 to the base 202. The attachment holes 203 are arranged in a selected pattern so that an adaptor 201 can be attached to the base 202 in a number of different positions. This beneficially allows a user or clinician to customize alignment of the adjustable socket system 100 relative to a prosthetic device attached to the adaptor 201.

[00102] As shown by example in Fig. 12, the base 102 can be attached to an adaptor system 250 for aligning a prosthetic limb in the adjustable socket system 100. The adaptor system 250 includes a shift plate 252 and an adaptor part 254 removably attached to the shift plate 252. The shift plate 252 is attachable to the base 102 via fasteners and includes a plurality of attachment holes 256 for attaching the adaptor part 254 to the shift plate 252. The attachment holes 256 are arranged such that the position of the adaptor part 254 on the shift plate 252 can be varied. This beneficially allows a user or clinician to customize alignment of the adjustable socket system 100 relative to a prosthetic limb attached to the base 102. Further, the adaptor system 250 can be an add-on module or accessory sold separately from the adjustable socket systems of the present disclosure.

[00103] In other configurations of the base, the connection between the longitudinal supports 104 and the base can be adjusted. Fig. 13 illustrates a base 302 having a base segment 302B and one or more connecting segments 302 A extending upwardly from the base segment 302B arranged to be connected to a distal end portion 352 of the longitudinal support 304. The connecting segment 302A defines two holes 354 A, 354B along the longitudinal axis of the connecting segment 302 A for receiving a pair of fasteners 356 A, 356B for attaching the distal end portion 352 of the longitudinal support 304 to the base 302. Optionally, an outer surface of the connecting segment 302A can define a seat 353 arranged to receive the distal end portion 352 of the longitudinal support 304. It will be appreciated that the base 302 and the longitudinal support 304 can be made of any suitable material such as carbon fiber, plastic, metal, or combinations thereof. [00104] The first fastener 356A can be threadedly attached to the hole 354A such that a head portion 358 A of the first fastener 356 A engages the inner surface of the distal end portion 352 of the longitudinal support 304. The second fastener 356B can be threadedly attached to the hole 354B such that a head portion 358B of the second fastener 356B engages the outer surface of the distal end portion 352 of the longitudinal support 304. The longitudinal support 304 is thus attached to the base 302 by the second fastener 356B, and the head portion 358A of the first fastener 356A forms a pivot about which the distal end portion 352 can pivot.

[00105] The position of the first and second fasteners 356A, 356B along the longitudinal axes of the holes 354 A, 354B can be varied to adjust an angle T defined between the distal end portion 352 and a longitudinal axis 316. For instance, the angle T can be increased by tightening the first fastener 356A and/or loosening the second fastener 356B in the holes 354A, 354B. The angle T can be decreased by loosening the first fastener 356A and/or tightening the second fastener 356B. This allows the longitudinal support 304 to be set at different angles relative to the longitudinal axis 316 for adjustment, improving the fit and support of the adjustable socket system 100.

[00106] Figs. 14A and 14B illustrate a base 402 including a first component 450, a second component 452, an adaptor 454, and a mounting plate 456. The adaptor 454 is adapted to be attached to a prosthetic limb and is shown as a male adaptor but can be a female adaptor or any other suitable adaptor. The first and second components 450, 452 are located between the adaptor 454 and the mounting plate 456. The first and second components 450, 452 are radially adjustable relative to one another to vary a circumference of the adjustable socket system 100. In an embodiment, the first component 450 slidably engages the second component 452 and can be locked into different positions with respect to the second component 452.

[00107] The base 402 forms an anatomically shaped receiving space adapted to receive the distal end of a residual limb. Each of the first and second components 450, 452 includes a base segment 458 and connecting segments 460 extending upwardly from the base segment 458. One of the connecting segments 460 can connect to a medial support and the other can connect to a lateral support. The connecting segments 460 define a plurality of openings 462 arranged to receive fasteners for attaching the supports to the base 402. The connecting segments 460 may have a width greater than the base segments 458, increasing the contact area between the supports and the base 402. Optionally, an inner surface of the connecting segments 460 defines a seat 464 arranged to receive a distal end portion of the support.

[00108] Each base segment 458 defines a plurality of elongated holes 466. A plurality of fasteners 468 extend through the elongated holes 466 and connect the adaptor 454 to the mounting plate 456 such that the base segments 458 are located between the adaptor 454 and the mounting plate 456. In use, the fasteners 468 can be loosened such that the base segments 458 can radially slide between the adaptor 454 and the mounting plate 456 relative to a longitudinal axis 416, which, in turn, adjusts the circumference of the adjustable socket system 100 via adjustment of the base 402.

[00109] The fasteners 468 can be tightened such that the base segments 458 are clamped between the adaptor 454 and the mounting plate 456, locking or fixing the radial position of the base segments 458 relative to the longitudinal axis 416. This advantageously allows the circumference of the base 402 to be continuously adjustable within a range defined by the elongated holes 466.

[00110] Figs. 15A and 15B illustrate a distal insert 550 that can be included with an adjustable socket system 500 of the present disclosure. The distal insert 550 is arranged to be connected to a distal end of a prosthetic liner and positioned on a base 502 of the adjustable socket system 500. The distal insert 550 can be integral to the liner or attached to the liner. The distal insert 550 defines an outer peripheral surface 552 and can be attached to the liner in any suitable manner. As seen, the outer surface 552 can define a plurality of ribs or corrugations 554 adapted to increase friction between the distal insert 550 and one or more shell components of the adjustable socket system 500. In an embodiment, the distal insert 550 can include one or more materials with a high coefficient of friction such as elastomeric polymers to increase friction between the distal insert 550 and the shell components.

[00111] According to a variation, the distal insert 550 communicates information to a user or clinician. For instance, a distal region of the outer surface 552 can include at least one colored band 556. The colored band 556 can be a bright color such as yellow, orange, or hot pink. When the liner is correctly positioned on the base 502, the colored band 556 can be visible through an observation window 558 at or near the base 502. This advantageously communicates correct positioning of the liner in the adjustable socket system 500. When the colored band 556 is not visible through the observation 558, its absence communicates incorrect positioning of the liner in the adjustable socket system 500.

[00112] With reference to Figs. 16 - 19, alternative embodiments of the adjustable socket system shown in Figs. 1 - 15 are illustrated. The alternative adjustable socket systems are radially adjustable and may include one or more shell components that are adjustable in length to better fit and support a residual limb.

[00113] As shown in the example in Fig. 16, an adjustable socket system 600 includes a base 602 and a plurality of longitudinal supports 604 connected to the base 602. The shell components and tightening system are not shown for ease of reference. The base 602 can include a distal cup 650 arranged to support a distal end of a residual limb and the longitudinal supports 604 can include a medial support 604A and a lateral support 604B, both arranged to pivot about a mid-region of the adjustable socket system 600. The longitudinal supports 604 can be formed of the same materials as the longitudinal supports 104.

[00114] The lateral support 604B has a multi-part configuration including a distal segment 652, a proximal segment 654, and a brim component 656 attached to the proximal segment 654. A distal end of the distal segment 652 is attached to the base 602 and a proximal end of the distal segment 652 forms a pivoting connection 658 with the proximal segment 654. The proximal segment 654 is pivotally attached to the distal segment 652 via the pivoting connection 658.

[00115] The proximal segment 654 overlaps the distal segment 652 in a longitudinal direction. A seat or receptacle 662 is located on the inner surface of the distal segment 652 for accommodating the distal end of the proximal segment 654. The seat 662 limits the distal end of the proximal segment 654 from sliding sideways on the distal segment 652.

[00116] The medial support 604 A is arranged similar to the lateral support 604B including a distal segment 664 fixedly attached to the base 602, a proximal segment 666 attached to the distal segment 664 via pivoting connection 668, and a seat 672.

[00117] In use, the proximal segments 654, 666 can independently rotate about the pivoting connections 658, 668 to radially reposition the distal and proximal ends of the proximal segments 654, 666 relative to a longitudinal axis 616 of the adjustable socket system 600. For instance, as a residual limb engages the distal ends of the proximal segments 654, 666 upon donning, the radial position of the proximal ends of the proximal segments 654, 666 rotate toward the longitudinal axis 616, loading the proximal region of the residual limb. This adjustment can help improve shape capture of the adjustable socket system 600 and adjustment of the circumference of the adjustable socket system 600. According to a variation, the distal end of at least one of the proximal segments 654, 666 is resiliently biased or spring loaded in a direction toward the longitudinal axis 616.

[00118] Fig. 17 illustrates an adjustable socket system 700 according to yet another embodiment including a base 702, a plurality of longitudinal supports 704 connected to the base 702, and a plurality of shell components 706 including first and second shell components 722, 720 connected to the longitudinal supports 704. Like in other embodiments, the adjustable socket system 700 is movable between an open configuration and a closed configuration via a tightening system 714.

[00119] The longitudinal supports 704 include at least one support 704B having a segmented configuration that can facilitate a length adjustment of at least one of the shell components 706. For instance, the second shell component 720 includes distal and proximal parts 730, 732 and the longitudinal support 704B includes a distal segment 750 removably attached to the base 702, and a proximal segment 752 removably attached to the distal part 750. A proximal part 732 of the second shell component 720 is attached to the proximal segment 752 and the distal part 730 of the second shell component 720 is attached to the distal segment 750 and/or the base 702.

[00120] The distal and proximal segments 750, 752 define a plurality of through holes 754 along a longitudinal axis of the lateral support 704B. The through holes 754 are adapted so that the proximal segment 752 can be attached at different locations along the length of the distal segment 750 with one or more fasteners 751, which, in turn, longitudinally displaces the proximal part 732 of the second shell component 720 relative the distal part 730. It will be appreciated that a medial support can be configured similar to the lateral support 704B and a first shell component 722 can be configured similar to the second shell component 720.

[00121] The tightening system 714 includes at least one tensioning element 762 operatively linked to first and second tensioners 764, 766. The first and second tensioners 764, 766 are shown as dial tensioners but can be any suitable tensioning mechanisms. The first tensioner 764 can be attached to a proximal portion of the lateral support 704B and the second tensioner 766 can be attached to an intermediate region of the lateral support 704B. The at least one tensioning element 762 can be formed of line, wire, cord, or any other suitable element.

[00122] The at least one tensioning element 762 is connected to the first and second tensioners 764, 766 and routed through a plurality of guides 768 located toward the lateral aspect of the system 700. The guides 768 comprise loops of fabric 770 on the first shell component 722. The fabric loops 770 can be integrated with or attached to the first shell component 722. Using fabric loops 770 as guides for the at least one tensioning element 762 allows for a degree of distal and proximal movement of the at least one tensioning element 762 relative to the first shell component 722 during use, which, in turn, allows the at least one tensioning element 762 better accommodate movement of the residual limb during a user's gait, making the adjustable socket system 700 more comfortable.

[00123] The fabric loops 770 can be attached to the first shell component 722 in any suitable manner. For example, the fabric loops 770 can be attached to an outer fabric layer of the second shell component 720 comprising a robust or durable material. The fabric loops 770 can be attached to a semi-rigid body of the first shell component 722 for reinforcement. According to a variation, the fabric loops 770 can include stitching to strengthen the fabric loops 770 and/or define a small channel configured to receiving the at least one tensioning element 762. This can help direct the at least one tensioning element 762 between the edges of the first shell component 722. The fabric loops 770 can be non-elastic or elastic and can comprise any suitable number of loops.

[00124] Fig. 18 illustrates an adjustable socket system 800 according to another embodiment including a base 802, a plurality of longitudinal supports 804 connected to the base 802, a plurality of shell components 806 operatively connected to the longitudinal supports 804, and a tightening system 814 for radially adjusting the adjustable socket system 800 between the open and closed configurations.

[00125] The longitudinal supports 804 include a medial support 804A and a lateral support 804B, but can be in any suitable configuration. At least one of the longitudinal supports 804 is pivotally attached to the base 802. In other embodiments, at least one of the longitudinal supports 804 has a non-articulating configuration adapted to bend or flex to adjust or vary the receiving volume of the adjustable socket system 800.

[00126] The tightening system 814 includes one or more tensioning elements 818 operatively linked to one or more tensioners 850 and connected to a lateral aspect of the adjustable socket system 800. The one or more tensioning elements 818 are routed through a plurality of guides 852 between the shell components 806 and the one or more tensioners 850.

[00127] The guides 852 are separate guide members 854 attached to the outer surface of a shell component 806 via fasteners 856. The connection between the guides 852 and the fasteners 856 can be such that the guides 852 rotate about the fasteners 856 when the one or more tensioning elements 850 are tensioned and loosened by the one or more tensioners 850, which, in turn, allows the relationship between the one or more tensioning elements 850 and a first shell component 822 to shift during use. This beneficially helps accommodate movement of the residual limb during a user's gait, making the adjustable socket system 800 more comfortable.

[00128] The removable attachment of the guide members 854 to the shell component 806 can also permit the guide members 854 to be repositioned on the shell component 806 based on the needs of the user or a particular indication.

[00129] Fig. 19 illustrates yet another embodiment of an adjustable socket system 900 including a base 902, a plurality of longitudinal supports 904 comprising a lateral support 904B and medial support 904A connected to the base 902, a plurality of shell components 906 operatively connected to the longitudinal supports 904, and a tightening system 914 arranged to radially adjust the adjustable socket system 900 between an open configuration and a closed configuration.

[00130] The shell components 906 include a first shell component configured to wrap around and engage at least the medial aspect of the residual limb and a second shell component configured to wrap around and engage at least a lateral aspect of the residual limb.

[00131] The tightening system 914 includes at least one tensioning element 918, guides 950, and at least one tensioner 952 operatively connected to the at least one tensioning element 918. The at least one tensioning element 918, which is shown as a cable or wire, is looped around the adjustable socket system 900 through the guides 950 on or near the lateral and medial supports 904A, 904B. The guides 950 can comprise through holes 954 in the longitudinal supports 904. [00132] The at least one tensioner 952 comprises one or more handles 956 including a hook or loop material that allows the handle 956 to selectively attach to an outer surface of at least one of the shell components 906, which, in turn, locks the position of the at least one tensioning element 918 and maintains tension, if any, in the at least one tensioning element 918.

[00133] At least some of the guides 950 on the medial support 904A and the lateral support 904B are longitudinally offset to loop the at least one tensioning element 918 through the guides 950 in a generally spiraling fashion along the length of the adjustable socket system 900. From the guides 950, the at least one tensioning element 918 passes through a plurality of pulley assemblies 960 connected to the base 902. The pulley assemblies 960 reduce the amount of force needed to move the adjustable socket system 900 to the closed configuration.

[00134] In use, a user can grip one or more of the handles 956 and pull on the at least one tensioning element 918, which, in turn, tensions the at least one tensioning element 918 and moves the adjustable socket system 900 toward the closed configuration. When a desired level of tension or loading in the adjustable socket system 900 is achieved, the user can attach the one or more handles 956 to the shell components 906, maintaining the tension in the at least one tensioning element 918. The pulley assemblies 960 increase a travel distance of the at least one tensioning element 918, decreasing the level of physical effort needed by the user to tension the at least one tensioning element 918. In other embodiments, the pulley assemblies 960 can be adapted to enable a user to apply a greater tension to the at least one tensioning element 918.

[00135] When the user desires to move the adjustable socket system 900 toward the open configuration or loosen the adjustable socket system 900, the user can detach the one or more handles 956 from the shell components 906, releasing the tension in the at least one tensioning element 918. The tightening system 914 thus provides an intuitive and simple manner for users with limited dexterity or cognition to adjust the fit of the adjustable socket system 900.

[00136] Alternative embodiments of shell components having an adjustable length are shown in Figs. 20 and 21. Figs. 20 A and 20B shows a shell component 1006 including a distal shell component 1020 and a proximal shell component 1022. A proximal end portion 1050 of the distal shell component 1020 defines a first plurality of teeth 1052 arranged to mesh or interact with a second plurality of teeth 1054 defined on a distal end portion 1056 of the proximal shell component 1022. The first and second pluralities of teeth 1052, 1054 are shown generally elongated but can have any suitable configuration. The shell component 1006 can be made of the same or similar materials as the other shell components of the present disclosure.

[00137] The shell component 1006 is adjustable in length. The shell component 1006 is movable between a first predetermined length PI in which the first and second teeth 1052, 1054 are substantially fully engaged and the distal and proximal shell components 1020, 1022 are longitudinally displaced toward one another, and a second predetermined length P2 in which the first and second teeth 1052, 1054 are at least partially disengaged and the distal and proximal shell components 1020, 1022 are longitudinally displaced away from one another.

[00138] A tightening system 1014 is adapted to move the shell component 1006 between the first and second predetermined lengths PI, P2. It will be appreciated that the tightening system 1014 can also be arranged to tighten the fit of an adjustable socket system on the residual limb as described herein. The tightening system 1014 includes a first plurality of guides 1056 positioned at or near the first plurality of teeth 1052, a second plurality of guides 1058 positioned at or near the second plurality of teeth 1054. The guides 1056, 1058 can be integral to shell component 1006 or attached to the shell components 1006.

[00139] A tensioning element 1060 is laced through the guides 1056, 1058 such that when the tensioning element 1060 is tensioned, the tensioning element 1060 pulls the proximal part 1022 away from the distal part 1020, moving the shell component 1006 toward the extended position. When the tension is released in the tensioning element 1060, the shell component 1006 can be arranged to automatically return to the default position.

[00140] The overall length of the shell component 1006 is thus continuously adjustable within a range defined by a length of the first and second pluralities of teeth 1052, 1054 and/or the tensioning element 1060. This continuous adjustability allows the length of the shell component 1006 to be adjusted in an infinite number of positions rather than being adjustable in discrete increments, providing greater versatility and functionality.

[00141] Figs. 21 A and 21B illustrate another shell component 1106 similar to the shell component 1006, except that the distal part 1120 and the proximal part 1122 are initially in the second predetermined length P2 (shown in Fig. 21 A) in which the distal part 1120 and the proximal part 1122 are moved away from one another in a longitudinal direction. From the second predetermined length P2, the shell component 1106 is movable into first predetermined length PI (shown in Fig. 2 IB) in which first and second pluralities of teeth 1152, 1154 are substantially fully engaged and the distal and proximal parts 1120, 1122 are moved together, reducing the length of the shell component 1106.

[00142] A tightening system 1114 is arranged to move the shell component 1106 between the first and second predetermined lengths PI, P2. The tightening system 1114 includes a tensioning element 1118 laced or threaded through a plurality of guides 1156, 1558 so that when the tensioning element 1118 is tensioned, the tensioning element 1118 moves the distal and proximal parts 1120, 1122 toward the first predetermined length PI . When the tension in the tensioning element 1118 is released, the shell component 1106 is arranged to automatically return to the second predetermined length P2.

[00143] A plurality of springs 1160 are disposed between the distal and proximal parts 1120, 1122. The springs 1160 are arranged to bias the shell component 1106 toward the second predetermined length P2.

[00144] Adjustable socket system embodiments of the present disclosure are radially adjustable between open and closed configurations. Figs. 22 - 26 illustrate alternative examples of these systems that open and close to help secure the adjustable socket systems on a residual limb. Figs. 22A and 22B illustrate an adjustable socket system 1200 including a prosthetic liner 1250 having a locking element 1252 corresponding to a slot 1254 defined on a longitudinal support 1204 or shell component 1206 of the adjustable socket system 1200. The locking element 1252 can comprise a locking ring 1258 or any other suitable structure.

[00145] Similar to other embodiments, the adjustable socket system 1200 moves between the open and closed configurations. As the adjustable socket system 1200 moves toward the closed configuration, the locking element 1252 locks into the slot 1254, counteracting a pull-out movement of the liner 1250 in a proximal direction from the adjustable socket system 1200. As the adjustable socket system 1200 moves toward the open configuration, the locking element 1252 releases from the slot 1254 as the supports 1204 and/or shell components 1206 move radially outward relative to the longitudinal axis of the adjustable socket system 1200. The locking element 1252 thus locks and releases with tightening and loosening of the adjustable socket system 1200.

[00146] Figs. 23A - 23C illustrate another adjustable socket system 1300 including a locking element 1352. The system 1300 comprises a prosthetic liner 1350 having one or more locking elements 1352 protruding from an outer surface of the liner 1350.

[00147] The locking elements 1352 can be a plurality of locking teeth 1358 arranged to selectively lock in corresponding holes 1354 defined in a longitudinal support 1304 and/or shell component 1306. As the adjustable socket system 1300 moves toward the closed configuration, the locking teeth 1358 lock into the holes 1354, counteracting a pull-out movement of the liner 1350 in a proximal direction from the adjustable socket system 1300. As the adjustable socket system 1300 moves toward the open configuration, the locking teeth 1358 release from the holes 1354 as the longitudinal supports 1304 and/or the shell components 1306 move radially outward relative to a longitudinal axis of the adjustable socket system 1300.

[00148] In an embodiment, the holes 1354 can be through holes such that when the locking teeth 1358 are locked in the holes 1354, the locking teeth 1358 protrude radially beyond the outer surface of the shell component 1306 and/or the longitudinal support 1304, providing visual feedback to a user. In other embodiments, as the locking teeth 1358 lock in and out of the holes 1354 they can provide audible and/or tactile feedback to a user.

[00149] Fig. 24 illustrates an adjustable socket system 1400 according to another embodiment, including a liner 1450 including a first plurality of locking teeth 1458 having a square shape arranged to interface with a second plurality of locking teeth 1460 defined by the support 1404 and/or the shell component 1406. As the adjustable socket system 1400 moves toward the closed configuration, the first plurality of locking teeth 1458 lock with the second plurality of locking teeth 1460, counteracting a pull-out movement of the liner 1450 in a proximal direction from the adjustable socket system 1400.

[00150] Fig. 25 illustrates an adjustable socket system 1500 similar to the system 1400 including a liner 1550 having a first plurality of teeth 1558. The first plurality of teeth 1558 have an angled configuration and the second plurality of teeth 1560 have a corresponding angled configuration.

[00151] Fig. 26 illustrates an adjustable socket system 1600 that includes a liner 1650 having a plurality of locking regions 1652 distributed circumferentially and extending longitudinally along the liner 1650. The locking regions 1652 can comprise strips 1654 can extend along the entire or a portion of a length of the liner 1650. The strips 1654 are arranged to interface with a corresponding structure on a longitudinal support or shell component to counteract a pull-out movement of the liner 1650 in a proximal direction from the adjustable socket system 1600.

[00152] The strips 1654 can include silicone adapted to mate with corresponding silicone on the inside of a longitudinal support of the adjustable socket system 1600. In other embodiments, the strips 1654 can include hook material arranged to mate with corresponding loop material on the adjustable socket system 1600. In yet other embodiments, the strips 1654 can include permanent magnets arranged form a magnetic attraction with ferromagnetic material on the adjustable socket system 1600. In other embodiments, the strips 1654 can include sticky material.

[00153] Adjustable socket system embodiments of the present disclosure thus provide improved support and fit over prior art systems. From its versatility in fitting and force distribution, the adjustable socket system embodiments can decrease pain, discomfort and soft tissue breakdown.