Gel liners are basically divided into three major categories based on material used.
- Silicon liners – they are made up of medical grade silicon, and usually, come with a pin shuttle locking mechanism. Commonly prescribed for patients with no pain in the stump and old age patients because of the easy locking and unlocking mechanism of the prosthesis.
Complication: – Patients with pain in the lower end of the stump do not feel comfortable with the silicon liner because of the tightness and compression at the distal end. They will feel immense pain while putting the weight on the prosthesis
Bulbous/ wide stump at the lower end: – Wearing the prosthesis with silicon liner in such cases is very difficult or the line has to be combined with soft foam liner which will make the prosthesis cosmetically unappealable.
- Copolymer/ thermoplastic elastomer gel liner: they are made up of medical grade copolymers to bring softness to the material which is why they are best suited for diabetic patients to prevent damage to the leg after prolonged use. They are also good for the bony stump as the floating property of gel inside the prosthesis helps to relieve the pressure from bony areas and prevent skin damage.
They are good for patients with dry skin as they contain medical-grade skin-friendly oil.
These liners are best suitable with suction socket mechanisms with total surface bearing but can also be prescribed with pin shuttle lock mechanisms in old-age patients and patients with less power in their hands.
Complication: – due to the softness of the material they are comparatively less durable than silicon liner, however: – the skills of the prosthetist while designing the prosthesis also plays the important role in the durability of liners.
PUR(Polyurethane gel liner) – these liners have a very good memory and elasticity which makes them suitable for all types of stumps but particularly prescribed in cases of the bony, irregular shape of stumps. the elasticity in the gel quickly dislocates from the high-pressure areas to the low-pressure areas and helps even the distribution of load inside the stump and provides a comfortable fit.
Fitting with the suction socket with total surface bearing gives the best results.
Disadvantage: comparatively costlier than other liners.