Amputation; Artificial limbs; Orthopedics; Surgery, Military
Figure 5 shows the oblique bucket, with symmetrical anterior and
posterior borders. Figure 6 one with the anterior border oblique, the
posterior border being cut away. Figure 7 shows the double obliquity,
downwards and backwards, of the bucket. The convexities of the bucket
and thigh piece, in the type which we consider to be the best, are
shown in figure 8 (convexity outwards), and figure 9 (convexity
forwards).]
In this the thigh piece is strengthened by two lateral steels (to the
lower end of which is fixed the leg piece) joined posteriorly by a
semicircular cross piece on which the ischium should rest (Fig. 13).
[Illustration: FIG. 10.]
[Illustration: FIG. 11.]
The usual form hitherto has been that shown in figure 10. The cross
piece was horizontal and formed simply a posterior semicircle; the
lateral steels were straight. Consequently in this pattern these
steels form a cone, in which the soft parts are not compressed on
the inner side, nor drawn outwards, as in the apparatus previously
described. Further, as long as the stump is not shrunken, the ischium
covered on its inner side by soft parts sinks into the bucket, and it
is the perineum which becomes the point of pressure (Fig. 11). Made
of leather, the perineal concavity soon loses its shape and really
no longer exists. Finally the bucket is circular, with the faults
inseparable from that shape (Fig. 12).
In cases where it is felt necessary to employ leather, all these
faults are easily corrected, by giving the cross piece the shape
which we have described for the wooden bucket, and by prolonging it
forwards through two-thirds of the corresponding circumference, in
the shape of an oblique bucket. (Dotted line in Fig. 12.)
If it is not strengthened, an oblique border of leather gives way, and
after a few months' use allows rotation. The leather which extends
from the termination of the metal ascends very steeply towards the
trochanter, whilst the posterior border of the bucket, which is
horizontal, curves downwards on the inner side to form the perineal
concavity.
[Illustration: FIG. 12.
FIG. 13.
FIG. 14.
The ordinary leather bucket is mounted upon two lateral steels, which
are joined by a posterior cross piece (Fig. 13). This framework is
shown in figure 10, and covered with leather in figure 12. If the
lateral steels are straight and divergent, this has all the defects
of the straight circular bucket. The concavity for the perineum, cut
out of the leather, soon loses its shape. It is, however, easy to
shape the cross piece as shown in figure 14, with a perineal concavity
and the anterior border oblique, following the dotted line in figure
12. By doing this and curving the steel uprights appropriately, the
correct form of the wooden bucket can be copied exactly in a leather
and steel apparatus. Such a correct apparatus is shown in figures 15
to 18.]
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