1. _Fitting of the bucket._--The first difficulty is easily got over. All that is necessary is to cut away the front of the lower half of the bucket, and to cover in this opening with a lacing piece of leather. The stump passes into the top of the bucket, comes out of this opening and then falls back into the enlarged lower end where it takes a direct bearing (Fig. 99). [Illustration: FIG. 99.--Limb with end bearing for amputation in the region of the condyles of the femur. Anterior part of the thigh bucket cut away to allow the insertion of the enlarged lower end of the stump.] 2. _Level of the knee joint._--It is clear that if the stump is too long it is impossible to fit a knee joint with a bolt right through at the same level as the opposite knee. The thigh piece would have to be prolonged downwards in order to allow of the insertion of this bolt. This arrangement would not affect walking, but would be unsightly in sitting because of the inequality in the length of the thighs. It is easy to overcome the difficulty by attaching the leg by two independent lateral hinge joints, without a bolt right through, using the stirrup-shaped fork and the double lock, if a peg is used. This method, as we have already stated, is not so strong, but this is to a large extent compensated for by the possibility of getting a direct end bearing. 3. _Direct end bearing and suspension._--If the stump is well covered with a good anterior flap and if the lower end of the bucket is accurately moulded upon it with an interposed layer of felt, the patient can walk directly upon the end of the stump, without it being necessary to carry the bucket up against the ischium, simple braces being used as the means of suspension. 4. There is nothing special about the braces or about the extending strap if the knee is free, nor about the method of attaching the foot. These limbs for long stumps do not require any spring to extend the knee, if one is wanted an artificial muscle is quite easily fitted. We have taken as our type an amputation through the femoral condyles. The covering of the stump is excellent, and pressure is taken upon tissues which are naturally adapted to it (the thick skin and fibrous tissue over the patella), specially if it has been possible to keep the patella in the flap and fix it across the cut surface of the femur (Gritti's operation). The mechanical points in the fitting of an artificial limb for an amputation through the knee joint are the same. But this amputation seems to us to be inferior to that through the condyles. The sacrifice of three centimetres in length is of no importance in an appliance with direct end bearing; and, on the other hand, disarticulation has several disadvantages:-- 1. The enlargement of the femoral condyles, without any compensating advantage. 2. The bearing upon the two condyles, separated by a groove. 3. The insufficient covering of the condyles by the thin skin of the front of the leg.