Amputation; Artificial limbs; Orthopedics; Surgery, Military
In figure 14 is seen the metal framework; in figures 15 and 16 that
of the apparatus covered with leather; in figure 17 the support upon
the ischium; and the possibility of making this appliance identical
with the wooden bucket will be observed (Fig. 18).
[Illustration: FIG. 15.]
[Illustration: FIG. 16.]
[Illustration: FIG. 17.]
[Illustration: FIG. 18.]
II. MODE OF SUSPENSION
_Suspension of the thigh piece_ is essential, and is all the more
important when the stump is short and consequently more liable to
slip out of the bucket. For this purpose support may be taken either
from the waist, upon the _prominence of the iliac crests_, or from
the _shoulders_ by means of braces. In the case of a long stump
(amputation below the middle of the thigh) only one of these methods
is necessary, we shall describe the usual methods:
_The waist belt_ (French system) for leather appliances.
_Braces_ (American system) for appliances of wood.
If the stump is short a combination of the two methods is best.
[Illustration: FIGS. 19 and 20.--Simple pelvic suspension,
with details of the joint at the hip.]
A. SUSPENSION BY MEANS OF A WAIST BELT.--_For the peg leg
made of leather_ the best method consists in placing a pelvic plate,
which is attached to the hip steel, below the iliac crest (Figs. 20 to
24). A belt attached to the extremities of this plate surrounds the
pelvis and passes above the iliac crest on the other side. The thigh
piece is attached to this support, on the outer side, by articulation
of the outer femoral steel with the hip steel; on the inner side, by
a perineal strap. Braces complete the method of suspension of the
apparatus (Fig. 21).
[Illustration: FIG. 21.]
The axis of the metal joint between the outer femoral steel and the
lower end of the T piece should be directly above the great trochanter
(Fig. 20).
The femoral steel often breaks in the neighbourhood of this joint
(Fig. 23); we have got over this difficulty by adding immediately
beneath it a joint which allows of abduction (Fig. 19). A perineal
strap limits this movement.
[Illustration: FIG. 22.
FIG. 23.
_Suspension from the pelvis._
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