Whatever advantage it may be thought to possess, in our opinion the artificial leg with free knee joint is only suitable for sedentary occupations; it is not suitable for manual labourers and particularly for agricultural labourers who are obliged to get about on rough ground. Hence it is not uncommon for a patient who has been provided with an American leg to come and ask for a peg leg. In figures 93 to 95 it will be seen that it is a simple matter to transform the limb into an articulated peg. It is only necessary to attach the stirrup-shaped fork of the peg to the thigh piece by the knee bolt, and to add the double lock. To this peg may be added, if desired, the show calf and foot described on page 32. The full artificial leg can be rebuilt whenever it is wished. [Illustration: FIGS. 93 to 95.] On the other hand, an articulated wooden peg leg, such as we have described under the name of the Federation leg, can be easily adapted for walking with a free knee. It is only necessary to unlock the knee joint and to add the artificial muscle or accumulator of elastic shown in figure 98. This supplies the extending force, the value of which we have shown on page 36. We consider that this appliance is excellent and we know patients who almost always walk upon the peg, but who sometimes use a free knee for short walks. The conversion is simple and requires no special care. Under these conditions the fixed foot is almost always used; there is nothing to prevent the fitting of an articulated foot, but we have already seen that there is no great difference in walking between the old-fashioned fixed foot of the Marks leg and the more or less complicated articulated feet of more recent design. [Illustration: FIG. 96. FIG. 97. FIG. 98.] II. Limbs without bearing upon the Ischium _For amputations through the condyles of the femur, and similar amputations_ (_disarticulation of the knee and very short stumps below the knee_). Certain orthopædists do not know how to fit an artificial limb to an amputation through the condyles of the femur; they come therefore to the conclusion that this is a bad operation, and ought to be replaced by an amputation above the condyles. The two objections raised to this amputation are:-- 1. That it is impossible to fit a wooden bucket because the bone at the lower end of the stump is larger than it is at a higher level. 2. That it does not leave enough room to fit an artificial knee joint at the right level. These two objections are not valid, and, on the other hand, this amputation allows us to fit an artificial limb with complete end bearing, and this is a great advantage.