(In England the standard patterns of artificial legs have for many years been made out of wood.—Ed.)
The adjustment to the stump is very exact; the contact with the surface where there is friction is soft and comfortable without padding; the appliance is light, strong and silent. The best woods appear to be English willow and lime. The bucket should not present any flaw or knot, this can be seen on the inner uncovered surface.
But we must emphasise the general fact that standardisation is impossible when the bucket is made of wood. For the other parts it is possible but not for the bucket, which must be made specially for each patient, hollows being made for each bony point, which must be marked out and felt for with the fingers. A plaster cast would appear more exact: but by this means we do not mark out the bony points. Good results cannot be obtained, if, as certain people have tried, linear measurements are sent to a workshop whence an apparatus is forthwith despatched to a patient whom the maker has never seen.
CHAPTER II
GENERAL PRINCIPLES OF FITTING FOR THE LOWER LIMB
Whether we are dealing with an amputation of the leg or an amputation of the thigh, the principle function of the artificial limb is to support the weight of the body. The bucket must therefore give support to this weight. Three bearing points are thus possible: at the base, upon the surface and upon the end of the stump.
1. Bearing upon the base.—The principal bearing is that which is taken by fitting the upper edge of the bucket under the bony prominences situated around the last joint preserved, i.e. the tuberosity of the ischium for the thigh, the head of the tibia for the leg.
2. Bearing upon the surface of the stump.—Certain makers attribute to this an importance which we believe to be imaginary, but which leads them to erroneous conclusions.