Even if it were true that under these long stumps it is impossible to insert an artificial foot for lack of space, the operations which we have enumerated above should be recommended if the flap can be cut in the way we have indicated. [Illustration: FIGS. 120 and 121.] Their great advantage--and the reason for retaining as much length of bone as possible--is that they allow walking directly on the stump without an apparatus. It is sufficient to have a circular shoe made by any shoemaker consisting of a heel more or less thickened surmounted by a lacing gaiter reaching halfway up the leg. Guyon's amputation constitutes the limit up to which this "elephant boot" is possible. It is an unsightly apparatus, but its simplicity and cheapness should be taken into consideration, for it is quite possible that a manual labourer, especially a countryman, to whom an artificial foot and an "elephant boot" are given, will reserve the former for Sunday and use the other for his daily work. APPLIANCES WITH ARTIFICIAL FOOT.--The wooden piece which partly encloses the stump consists of a block carved to the shape of the stump and padded with felt, it is prolonged in front by an instep reaching to the level of the middle of the metatarsus, and above by a grooved piece which reaches halfway up the leg and encloses the anterior half of the latter. A leather gaiter is fixed at the sides and back and extends up the leg, being laced in front over the wooden piece as a field boot is laced over the leather tongue. The foot may be mounted at right angles to the leg, but it is better mounted slightly in equinus. The sole and toes are of rubber as described on page 35. In studying figures 120 and 121 the following should be noted:-- 1. The shape of the leg bucket in which an aperture behind permits the introduction of the stump which is enlarged at its lower end. 2. The mechanism by which the posterior gaiter laced in front fixes this leg bucket. 3. The articulation of the foot on a transverse axis. _CHAPTER VI_ PARTIAL AMPUTATIONS OF THE FOOT This name should be applied to amputations in which the mobility of the ankle joint is retained, _i.e._ Chopart's amputation (midtarsal disarticulation), Lisfranc's amputation (tarso metatarsal disarticulation), amputation of several toes with their metatarsal bones, or amputation of all five toes.