Nothing need be added to what has been said in the previous chapter about the elbow joint or the hand.
In the fitting of an attachment over the shoulder the amputation through the deltoid presents an actual advantage. For in this case the shape of the point of the shoulder is preserved, and the attachment carried out as described on pages 87 and 130 fixes the appliance very securely.
If the entire humerus has been removed a very extensive enclosure of the front and back of the chest is essential and in order that the axilla may be in close contact with the top of the limb it is a good thing to stretch across this space a layer of some firm material.
These appliances can be used to steady a piece of paper upon which the patient is writing, to carry a parcel which is not too heavy with the elbow flexed, to grip an article with the thumb. A workman who is being re-educated for some occupation which is possible for a one-armed man, will usually—unless he is going out for pleasure—leave his artificial arm at home in the cupboard.
CHAPTER X
SOME GENERAL PRINCIPLES IN THE RE-EDUCATION OF THE DISABLED
When a disabled man has been fitted with an artificial limb he has to learn a trade which will enable him to supplement his pension and provide for himself and his family. In our opinion, which we believe we have expressed more than once in this book, it is nearly always advisable to determine what profession will ultimately be possible before ordering the artificial limb. This principle is perhaps not always thoroughly understood, although there are fitting centres where it is fully recognised (a proof of this may be found in a recent article by Nové-Josserand and Bouget).
It is unnecessary to repeat that whilst every effort must be made to associate form with function, the latter is bound to take precedence of the former. It is, however, not always easy to impress upon patients, and more especially upon their protectors, that form is for Sundays and holidays, and function is for workdays.