Fig. 104.—Anterior view of the same limb.
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.