Artificial limbs and their relation to amputations.

  • Great Britain. Ministry of Pensions
Date:
[1939]
Catalogue details

Licence: Public Domain Mark

Credit: Artificial limbs and their relation to amputations. Source: Wellcome Collection.

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    (2) With Moore’s Outside Control—This type is designed for those who require central knee-control but whose stumps are so long that, if central control were fitted, the end of the stump would touch the pulley-bracket that rises about one inch above the knee centre. It provides an action approximating as closely as possible to central knee- control, but it is now rarely used, as it is, fortunately, rare to find a stump amputated so close to the knee-joint. (3) With Four Point Suspenston.—This type is used mainly for those wearing Anglesey-type legs, and for women patients in conjunction with a belt. It is a form of suspension rather than one of control, and therefore, does not, render the stump any assistance. It is not prescribed now for new cases. (4) With Three Point Suspension.—This type is merely an alternative form of (3) above and is used for the same class of case. 5. EXAMINATION OF THE ARTIFICIAL LIMB—ADVICE TO PATIENTS—FAULIS IN ARTIFICIAL LIMBS Examination of the artificial limb.—A new or refitted limb should be examined before the patient is allowed to take it away to ensure that :— (i) the manufacturer has constructed the limb exactly in accordance with the requirements of the height of the patient ; (ii) the surgical requirements for fit of socket and alignment of leg have been met; and (iii) the patient is able to make proper use of the limb and thoroughly understands its functions and their value. Understanding by the patient of the functions and mechanism of the limb is important since modern limbs are fitted with a number of new attachments, such as adjustable knee brakes, compression springs, and knee locks, which cannot be appreciated without proper knowledge of their use. The limb-makers should instruct the patient on these points, but very often such instruction needs repetition and amplification by the time the patient attends with the completed limb to see the surgeon. The examination of the limb should be carried out in a fixed, routine, and systematic manner. In describing this routine it will be assumed that the patient has been supplied with a stump-controlled limb, fitted with a double-swivel pelvic band, standard adjustable knee, internal knee spring, metal socket, and shaped container. (1) The fit of the socket-——When examining a limb to discover what repairs of a mechanical nature are required it is customary to commence the examination at the top, i.e., the pelvic band, if one is fitted, and to work downwards to the foot, so that the risk of missing a part of the limb is negligible. This method cannot be adopted, however, when examining the limb on the patient, because the relative positions of the various parts of the pelvic band are dependent upon the correct relationship of the ischial tuberosity to the tuber margin of the socket and the examination must therefore commence at the socket. When a primary-amputation stump is fitted only one stump sock is worn, since shrinkage may occur before much time has elapsed, and it is necessary to see that the patient has but one sock on the stump, for the wearing of two at this stage would indicate that rapid shrinkage had
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