1. For the ordinary amputations with bearing upon the top of the leg. [Illustration: FIG. 102.--Limb fitted upon the patient. Note that he stands upon the toe, and that the knee is flexed. ] [Illustration: FIG. 103.--Posterior view of the same limb.] [Illustration: FIG. 104.--Anterior view of the same limb.] 2. For amputation very low down with end bearing upon the extremity of the stump. I. APPLIANCES WITH BEARING UPON THE TUBEROSITIES OF THE TIBIA An artificial limb for amputation through the leg with a free knee joint is composed of two parts: a leg piece (with foot) which is fitted to the bony prominences around the top of the stump and supports them; and a suspensory apparatus which consists of a lacing thigh corset. A. LEG BUCKET.--The points on which the top of the bucket must be fitted are the internal tuberosity and the anterior tubercle of the tibia, and the head of the fibula, so that hollows corresponding to these must be carved out. Pressure upon the head of the fibula is often painful, and a deep concavity is therefore carved out for it. The pressure then comes upon the external tuberosity of the tibia which, however, ordinarily bears little weight. Whenever possible direct end bearing upon the termination of the stump should be used as an accessory to relieve the weight upon the tuberosities of the tibia; this is obtained as described on page 7. It is only possible if the scar is lateral and if there is a good thick posterior or external flap (in the upper third of the leg). An anterior flap is the least satisfactory. It is also advisable-- That the inner surface and the anterior border of the tibia be divided obliquely, and that the fibula be divided at a higher level than the tibia. The fibula must not take weight, it is too slender. In high amputations it has a tendency to tilt outwards, causing the double inconvenience of widening the stump and of projecting through the skin. If only 4 or 5 cms. of the fibula remain it is perhaps best to disarticulate and remove it. With a fitting arranged in this way, we consider that the convenience of walking with a free knee can be assured to patients whose stumps measure only 10 cms. from the lower border of the patella. These principles can be applied to a limb constructed either of wood or of leather. _The leather appliance_ (French method) is formed of a leather cylinder, strengthened by two laternal steels which articulate at the level of the knee joint with two similar steels in the thigh corset. Its upper edge may be strengthened anteriorly by a metal plate, but in practice the latter cannot be made to fit with precision the bony prominences enumerated above. It is actually the edge of the leather, adjusted by lacing, which supports tibial tuberosities, and therefore the precision of the fit is soon lost. For this reason, for amputation below the knee, the American method of construction with a wooden bucket is demonstrably superior.