Custom Prosthetic Services Ltd.
   
LOWER EXTREMITY PRODUCTS


Custom Prosthetic Services Ltd. specializes in the fitting of lower extremity prosthetic devices. Statistically these are the most common types of prostheses required by persons with limb amputations. Geoffrey Hall, our Canadian Certified Prosthetist, and Scott Hamilton, Registered Technician, are familiar with the complete range of componentry and materials used in the manufacturing of both traditional and modern state-of-the-art artificial limbs. We are committed to working closely with our clients to produce devices that are comfortable, functional, appropriate for their needs and cosmetically attractive. The following is an overview of some of the products relating to this area of prosthetics. Please contact us at our office to discuss your needs.

There are seven basic prosthetic options to consider for the person with a lower extremity amputation:

Partial Foot Prosthetics

Complete Prosthetic Feet

Shock Absorbers and Rotators

Prosthetic Knees for Artificial Limbs

Prosthetic Interface Materials

Prosthetic Socket Design and Suspension

Cosmetic Covers


Partial Foot Prosthetics

Partial foot amputations are fit with prosthetic devices ranging from simple toe-fillers in shoes for toe amputations, to custom-molded silicone prosthetics that incorporate contoured arch supports and carbon fiber keels. A comfortable fit, control of weight-bearing forces and adaptation to the needs of each individual are the most important features of this type of prosthesis. In some instances it may be necessary to purchase slightly larger or extra-depth shoes to accommodate the arch support or prosthesis required.

For persons with Diabetes, a comfortable and supportive pair of shoes with a soft sole and uppers is important to safeguard feet against any further injury.

Partial Foot 1 Partial Foot 2
Partial Foot 3
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Complete Prosthetic Feet

Prosthetic foot design and construction has progressed tremendously in the past few decades and now commonly incorporates carbon fiber structures to reduce weight and improve energy return. Some feet have terrain adapting and shock absorbing features, while others are more suitable for special purposes such as swimming. Most high-end feet can be ‘tuned’ to suit each individual by adjusting or exchanging internal elastomer bumpers or wedges, and are custom ordered from the manufacturer to specifications for each client. Prosthetic feet are selected by considering each individual’s activity level and the type of terrain that they will be traversing. We encourage our clients to become familiar with the different types of prosthetic feet available, to assist in the selection of the most appropriate type for them.

Prosthetic feet, like knees, hips, and other components incorporated into a prosthesis, can be grouped according to a recognized functional level classification system:

1. Low Impact Level:

Daily activities involving limited and steady walking with the use of a walking aid.

Example: Ambulation at home, limited in community.

2. Moderate Impact Level:

Daily activities involving normal walking, with the ability to demonstrate varied cadence.

Example: Community ambulation with confidence.

3. High Impact Level:

Daily activities involving fast walking, jogging and climbing stairs.

Example: Light manual labor, recreational sports.

4. Extreme Impact Level:

Daily activities involving rigorous walking, running and heavy lifting.

Example: Heavy manual labor including lifting, track and field sports.


SACH, Solid Ankle Cushioned Heel (Low Impact Level)

This foot has a wedge-shaped cushion in the heel that compresses with each step and a simple internal supportive structure embedded in a foam cosmetic shape. These feet can be quite light and are also suitable for prostheses intended for use around water.

Sach Foot
Sach Foot


Single Axis (Low Impact Level)

A hinged ankle joint is incorporated into the prosthetic foot. Rubber bumpers within the ankle structure absorb ankle motion induced by body weight.

Dycor Foot
Dycor Foot


Multi Axis (Moderate Impact Level)

Rubber bumpers in the ankle mechanism permit a rocking motion of the foot from heel to toe as well as from side to side. This can be useful for walking on uneven terrain. Generally these feet do not have much stored energy return and they have a softer feeling underfoot than the SACH feet.

Endolite Foot
Endolite Foot


Stored Energy (Moderate to High Impact Level)

These feet have an internal structure that acts like a spring. This spring will store energy and return this energy to the amputee, propelling them forward, as the toes of the prosthetic foot leave the ground. Some of the designs are virtually maintenance-free, while others incorporating internal bushings and bumpers require regular servicing to maintain optimal performance. Most of these feet have terrain-adapting features that absorb irregularities in the ground and improve performance on inclined surfaces. Some of the photos show the prosthetic feet without their accompanying cosmetic covers.
ID25 Foot
ID25 Foot
IC40 Foot
IC40 Foot
College Park Foot
College Park Foot
Genesis II Foot
Genesis II Foot
Talux Foot
Talux Foot
Luxon Foot
Luxon Foot
Luxon DP Foot
Luxon DP Foot
Modular III Foot
Modular III Foot
Sureflex Flex Foot
Sureflex Flex Foot
Variflex Flex Foot
Variflex Flex Foot
Advanced Features Stored Energy (Moderate to High to Extreme Impact Level)

These feet incorporate multiple features such as energy storage and return, shock absorption and rotation, and terrain adaptation. Suitable for prolonged walking, running and jumping they can be used both in daily ambulation and in sports.
Ceterus Foot
Ceterus Foot
Pathfinder Foot
Pathfinder Foot
Reflex VSP Foot
Reflex VSP Foot
Sprinting Foot – Special Feature:

Andrea Holmes uses the Flex Foot CHEETAH racing foot to help her achieve new personal bests in the 100-metre, 200-metre and long jump track and field events. Andrea has already established herself as an all-round athlete throughout her school career, participating in volleyball, basketball, baseball, tennis, golf, skiing, swimming, snowboarding, and track. When she approached Geoffrey Hall at Custom Prosthetic Services with the request to have a special-purpose track prosthesis made, the CHEETAH foot was selected for its lightweight and high-energy return features.

Built without a heel section, the CHEETAH foot is not meant for normal walking, and is best suited for strictly track and field events. Marathon running, basketball, baseball and other sports require the use of other types of prosthetic feet. Ask us at Custom Prosthetic Services Ltd. for the best foot and socket interface design and materials for your day-to-day and recreational needs.

Let's all cheer Andrea on as she sets her sights on representing Canada in track and field at the 2004 Paralympic Games in Athens, Greece!
Andrea Holmes
Andrea Holmes
Andrea Holmes Prosthesis
Andrea Holmes Prosthesis
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Shock Absorbers and Rotators

Rotators, with or without accompanying shock absorbers, are good additions to most lower extremity prosthetic devices. While they do add weight to a prosthesis, they reduce torsional stress on tissue. A rotation unit is definitely an asset to playing golf, and some units can be ‘tuned’ to suit the preferences of each individual.
4R85 Torsion Adapter
4R85 Torsion Adapter
Delta Twist Shock Absorber
Delta Twist Shock Absorber
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Prosthetic Knees for Artificial Limbs

Like prosthetic feet, the type of prosthetic knee selected for each individual is determined based on their intended activity level and the type of terrain that they will be traversing. These knee units can be similarly grouped into categories associated with the four main Impact Levels.

Children, Youth and Adults have access to many of the same classifications of knee units, built to suit their weight range and activity levels.
Contact us at Custom Prosthetic Services Ltd. to inquire about various prosthetic knee options.

Single Axis Constant Friction Knees (Impact Level Low)

This is a basic knee where the friction is set for each patient’s walking speed. The knee will feel stiff if the person is walking slower than the setting and not stiff enough if walking faster.

Single Axis


Safety Knees (Impact Level Low)

This is a single axis knee as described above, but includes a locking mechanism that will engage when the person places weight on the prosthesis, preventing the knee from buckling. This lock is released when the toe of the prosthetic foot is in contact with the ground and weight is transferred off of the prosthesis.

Safety Knee


Manual Locking Knees (Impact Level Low)

A Manual Lock feature can be added to many knee designs and would usually be used by very low impact level individuals, who need to ambulate with no possibility of the knee bending, unless the lock is manually released.

Locking Knee


4 Bar Knees (Impact Level Low to Moderate unless it is combined with pneumatic or hydraulic control for High)

This type of knee is designed to have more than one center of rotation throughout the bending cycle and in this way mimics the human anatomical knee joint. This design creates a stabile more easily controlled knee at the heel contact moment of the gait cycle and has a smooth action from mid-stance until the toe leaves the floor at the beginning of the swing phase portion of the gait cycle. Each knee is designed or can be adjusted to increase or decrease the initial centre of rotation and this influences knee safety. This type of knee also has less length in swing phase to improve toe clearance and is particularly suited for persons with a long trans femoral or knee disarticulation amputation.

These knees can have a constant friction brake and an adjustable knee extension assist to adjust to the gait speed of each person, or they can include either pneumatic or hydraulic swing phase control units. These features will determine performance levels of the knees.

4 Bar Knee


5 to 7 Bar Knees (Impact Level Low to Moderate unless it is combined with pneumatic or hydraulic control for High)

These knees are designed for additional safety and even smoother function than the 4 Bar Knees. Again, these can include pneumatic or hydraulic swing phase controls for greater function.

Total Knee


Pneumatic Swing Control Knees (Impact Level High)

A pneumatic cylinder is installed in the knee that uses principles of fluid mechanics to vary the resistance of the knee as the user changes their walking speed. This allows the individual to walk at different cadences and have the prosthetic knee keep pace to ensure the prosthesis is always in the correct position for safety when placing weight onto the prosthesis at heel contact. Pneumatic knee units are usually lighter in weight and less heavy duty than hydraulic knees.

Pneumatic Knee


Hydraulic Swing Control Knees (Impact Level High)

A hydraulic fluid cylinder is installed in the knee that uses principles of fluid mechanics to vary the resistance of the knee as the user changes their walking speed. This allows the individual to walk at different cadences and have the prosthetic knee keep pace to ensure the prosthesis is always in the correct position for safety when placing weight onto the prosthesis at heel contact. Hydraulic knee units are usually heavier duty than pneumatic knees.


Hydraulic Swing and Stance Control Knees (Functional Level III)

These Hydraulic knees can be set to different modes such as free swinging for bicycle riding, or slow resistance for descending steps foot over foot. It is also and excellent safety feature for stumble recovery.
Hydraulic Swing Control Knee
Hydraulic Swing
Control Knee
3C1 Knee
3C1 Knee
Mauch Range
Mauch Range
Stance Flexion Feature:

This feature allows the knee to bend slightly at heel contact without the knee buckling on flexion. This feature acts as a shock absorber, the same as the human anatomical knee.

Pneumatic Knee


High Technology Knees (Impact Level Moderate to High to Extreme)
The Otto Bock 3C100 C-Leg System


The C-Leg Micro processor knee system provides optimal stability during the gait cycle. Multiple sensors in the C-Leg records information more than 50 times per second resulting in reproducing the closest possible natural gait for the amputee.

This new dimension provides stability and security whilst walking down stairs, ramps and all uneven terrain.

We are pleased to discuss the benefits of this system with our clients. Contact us for more details.
C Leg
C Leg
Otto Bock C Leg 1
Otto Bock C Leg 1
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Prosthetic Interface Materials

A prosthetic interface is that material located closest to the wearer’s skin, whether it be the traditional fine nylon sheaths and stump socks or the newer urethane, polymer gel and silicone liners with or without integral suspension pins. At Custom Prosthetic Services Ltd. we strive to match each individual with the most appropriate interface and prosthetic suspension system. Each type of system requires routine cleaning to maintain good hygiene and healthy skin. We also carry a number of skin care lotions and ointments to be used separately from or together with the various types of gel liners. Considerable relief from pressure and friction-related skin problems and effective management of persistent scar tissue can be obtained through the use of a carefully shaped and supportive prosthetic socket coupled with the correct interface material.

Roll-On Gel Liners:
Roll-On Gel Liner Roll-On Gel Liner
Roll-On Gel Liner Roll-On Gel Liner
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Prosthetic Socket Design and Suspension

Custom Prosthetic Services Ltd. provides state-of-the-art prosthetic socket design and components. Comfort begins with a properly designed socket. We use careful hand-casting techniques and build prostheses that both support weight bearing and relieve pressure regions. We use flexible inner socket liners to allow the limb musculature to expand and contract throughout the gait cycle. In our above-knee prosthetic designs this flexible liner is supported by a lightweight rigid frame, which attaches to the prosthetic knee of choice. Many types of prosthetic suspension systems, including suction fitting and locking pin mechanisms are used. We use all of the advanced technology feet that will enhance the function of each prosthesis.
Socket & Insert
Socket & Insert
Pin Suspension Liner
Pin Suspension Liner
Trans Femoral
Trans Femoral
Transverse Detail
Transverse Detail
Harmony VASS (Vacuum Assisted Socket System)
Total Environment Control and Suction Suspension System


The Harmony VASS system is a recent significant advance in the technology of prosthetic suspension and volume control. Used correctly, the system offers many benefits over conventional prostheses including: unrestricted vascular flow (healthier for the tissues); control of swelling and edema; volume management; and enhanced linkage of the prosthesis to the residual limb. An excellent choice for active individuals with below or above knee amputations.

The VASS self-contained suction pump is linked to the interior of the prosthetic socket and it maintains a low pressure environment therein, while a flexible sealing sleeve prevents air entry at the socket brim. A urethane gel liner is worn directly over the skin of the residual limb to absorb shear and impact forces. The extra weight of this system is not a significant problem due to the feeling of being 'linked' solidly to the prosthesis. The VASS system can be retrofit to many existing prostheses or incorporated directly into the PATHFINDER foot.


Harmony VASS
Harmony VASS
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Cosmetic Covers

Custom Prosthetic Services Ltd. can provide very realistic looking cosmetic covers over below knee and above knee prostheses using custom colored latex and silicone skins. Inquire for more details.
Cosmetic Cover Cosmesis
Cosmesis 7
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