Amputation; Artificial limbs; Orthopedics; Surgery, Military
But _leather_--indespensable for certain stumps which cannot stand
a wooden bucket--has the advantage that it can be employed as a
_temporary fitting_. During the first weeks, sometimes even for the
first months, the shrinking of the stump can be accommodated by lacing
up the bucket, and, when shrinkage is complete, the leg part of this
first apparatus can be attached to a wooden bucket which the improved
condition of the stump now renders possible.
This form is a little more expensive (80 frs.) than "the poor man's
leg," but I believe a great deal more comfortable. It may be added,
that it is easy when the foot is fitted at the end of the apparatus
to render flexion of the knee free and to attain the "American walk,"
of which we shall speak later. All that is necessary is to attach in
front an artificial muscle of indiarubber, reaching from the thigh to
the leg and an extending sling like that in the American limbs (see
page 47).
This appliance which we call the "Fédération Leg," because we designed
it at the _Fédération des Mutilés_, has already been imitated without
its origin being acknowledged.
IV. WALKING WITH FREE FLEXION OF THE KNEE
A. _Design._--The oldest type, which will suffice for studying the
general conditions of stability, is that of Marks, with a fixed
foot shaped out of the same piece of wood as the leg: the ankle
joint--several types of which we shall describe later--does not affect
the question of stability.
The appliance is made entirely of wood; it is strong and light.
Nothing need be added to the description already given of the fitting
and method of attachment of the thigh piece, which ends below in a
curved "condyle,"[4] which fits into the top of the leg piece. It
is transfixed by a metal bolt, from each end of which a metal plate
descends and is riveted into a corresponding groove in the leg.[5]
This forms the axle which rotates in the thigh piece when the knee
flexes or extends. Flexion of the knee is free. Extension is stopped
just short of the straight line (see p. 16).
[4] The bucket and the condylar portion are made of two separate
pieces of wood.
[5] The hole through which the bolt passes being cut in soft wood
(willow or lime), must be strengthened by a cylinder of metal, of
leather, or of harder wood (beech or service tree) in which the axle
revolves.
[Illustration: FIG. 48.--Marks leg with fixed foot.]
[Illustration: FIG. 49.--Construction of the foot.]
The foot is in equinus at an angle of 25° to 30° so that the heel
is 2 or 3 centimetres from the ground (the usual height of the heel
of a boot). The piece of wood which forms the instep and which is
continuous with the leg stops at a point corresponding to the middle
of the metatarsus, and is only half the thickness of the foot. The
rest of the foot is shaped of indiarubber stuck on to the instep
piece; the wood and rubber being enclosed in a sheath of leather.
Public-domain text, read in full here on John Shaqi.
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