Clinical Case Report: Utilizing Adjustable Socket System for Managing Unstable Residual Limb Edema in a Complex Diabetic Transtibial Amputee

Transtibial amputation (TTA) in diabetic patients presents significant clinical challenges, particularly when complicated by unstable residual limb edema, leading to poor prosthetic fit, pain, and severely diminished quality of life. This report details the successful management of a complex 65-year-old male diabetic patient, classified as a K2 functional level (limited household ambulatory), who suffered from highly fluctuating stump volume. The patient was treated using the RevoFit™ adjustable socket system (Click Medical). Pre-intervention, the patient reported high daily pain (VAS 6.5) and a daily step count of approximately 450 intermittent steps. A modified Patellar Tendon Bearing (PTB) socket was designed, integrating the RevoFit™ system for immediate circumferential pressure control. Post-intervention results demonstrated a significant improvement within the K2 classification: average pain decreased to 1.2, the PEQ-QoL score increased from 35 to 88, and the daily step count increased to 900 intermittent steps. Crucially, the daily stump circumference fluctuation was reduced from 13.0% to 2.5%. This case report underscores the efficacy of adjustable socket technology in providing a practical solution for managing residual limb volume changes, thereby maximizing functional capacity and quality of life even within the limitations of the K2 functional level.