Amputation; Artificial limbs; Orthopedics; Surgery, Military
1. _The Arm Socket._--We have already said that this must be continued
into a shoulder cap of considerable extent, which may be perforated
in the region of the point of the shoulder in order to render the
appliance lighter. Abduction at the shoulder is thus sacrificed.
The arm socket is made of leather, open down the front and laced. By
being laced it fits the stump more securely. It is strengthened by two
steels which may be fixed in the frontal plane because, as we shall
see, a passive rotation at the elbow joint is possible.
These steels are directly continuous below with a hemispherical steel
cap, which is pierced in the axis of the limb by a hole into which is
bolted the connecting piece to which the rod which represents the
forearm is attached.
2. _Articulation at the Elbow._--The forearm consists of simple metal
tube, attached beneath the arm socket by methods which depend upon the
following principles.
[Illustration: FIGS. 208 and 209.--_Worker's arm and show
arm._
The worker's arm consists of a metal rod which swings backwards and
forwards at the elbow and also rotates upon the arm socket. To the
end of this rod an appliance can be screwed (a ring and hook are here
shown). Around the worker's arm a show arm with a hand (Fig. 209) can
be fixed. They are shown in place in Figure 210.]
The only movements that the stump can transmit to the arm socket
are forward and backward movements hinging about the shoulder, and
abduction. The first of these movements is the only really useful one
for the workman. The downward pressure exerted by active extension of
the elbow no longer exists; in order to press upon an object the sound
hand must be used, for it is not practicable to make use of the weight
of the body thrown forward for this purpose.
[Illustration: FIG. 210.--Show arm in position.]
In backward and forward movements--considering, for example, the use
of the file--the angle at the elbow opens when the arm is thrust
forward and closes when it is pulled backwards. These passive
movements of the joint must not be impeded in any way, that is to say,
the forearm must swing freely below the arm upon a transverse axis and
it must also be able to rotate freely around a vertical axis.
These movements are secured in the ploughman's hand which was designed
sixty years ago by Gripouilleau and in which the joint which we
have shown as a method of attaching the mobile ring to the wrist is
utilised. The forearm rod attached by a strong transverse pin swings
freely in a little stirrup-shaped cap, which itself rotates around a
bolt by which it is firmly fixed into the metal or wooden hemisphere
which terminates the arm socket.[14]
[14] Wood, which was used by Gripouilleau, has been given up.
Public-domain text, read in full here on John Shaqi.
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