The Brunet grip is an actual pair of pliers, shaped like these and furnished with a powerful spring. It is opened by a cord like that of the automatic thumb. Figures [158 to 160] explain the mechanism. It is an excellent appliance with which the wearer can carry out the majority of the actions of everyday life. It has, however, the disadvantage that it is not shaped like a hand—a point to which patients attach much importance—and, moreover, it is a part of a patented appliance, for which an interchangeable hand is not manufactured. So that in order to have in addition an artificial hand, which is capable of being removed and replaced by one or more of the appliances which will be described later, it would be necessary for the patient to possess two complete artificial limbs, and changing from one to the other would evidently be inconvenient.
We generally prescribe this appliance for patients who have lost both arms, for one side and as a supplementary appliance.
There are other similar models into details of which it is unnecessary to enter. Those in which the grip is opened by movements of pronation and supination are obviously only suitable for certain rare cases (very long stumps, with free movement).
B.—Appliances for Use in Place of the Hand.
The general principle is to fit to the end of the forearm piece an attachment which can be screwed on or unscrewed at will and which carries an appliance which is adapted to the various more or less specialised movements of the patient's trade.
Naturally the results thus attained must always be imperfect; but however little perseverance and ingenuity he may possess, the patient finds that he is able to educate the remaining arm, even when it is the left, to replace the amputated one in a way that is often remarkable. It is to this education that attention must be specially directed in the workshops for the re-education of the maimed.
1. Knife and Fork.—The first necessity is to be able to eat, and by certain very simple devices a fork, spoon or knife may be fixed to a wooden hand, whether the thumb be mobile or not.
As a general rule if the patient has one arm intact, he uses the sound hand only for this purpose, but when both forearms have been lost an appliance is indispensable.