Much, of course, depends upon the condition of the patient, in circumstance and constitution. It many times occurs that while the edges of the flaps have united, and cicatrization appears, ossification at the sawn end of the bones has not taken place, consequently the necessary pressure and tension on the surrounding integuments and other adjacent parts in wearing a leg will unavoidably cause inconvenience, irritation and pain. It is therefore our opinion, based upon experience and observation, that in most cases an artificial leg should not be fitted within three months after amputation, and that if the edges of the wound have thoroughly united at the end of that time it is unnecessary to wait longer, except to harden and reduce the stump by bandaging, if this has not previously been done. There are many good reasons why a leg should be applied as soon as practicable after this time (provided that the stump has healed), the chief one being that there is nothing that will discipline and strengthen a stump and remaining joints as quickly and as effectually as the use of a properly fitted artificial leg.
Material of Construction
The materials used in the construction of artificial limbs are, principally, tough English willow, leather, metal and rubber. The wood parts, when worked to the desired shape, are covered with parchment or rawhide and finished with a flesh-tinted waterproof enamel.
Artificial Legs for Children
When children have been deprived, by accident or disease, of one or both lower limbs, artificial legs should be applied as soon as the condition of the stump will safely permit. It is too generally presumed that an outgrown limb is of no further use, and that the purchase of an artificial leg before full growth is assured means a foolish expenditure.
This is wrong, at least so far as our work is concerned; there are artificial legs made that it would be very expensive to lengthen or change, but any leg that is made by us, or under our name or supervision, we will agree to lengthen at any future time, as necessity may arise, at a cost not to exceed five dollars, and in many cases not to exceed three or four dollars. When the amputation is above the knee, it is often necessary that the leg be lengthened both above and below the knee-joint. This involves more labor and consequently greater expense, but in no case will the charge exceed five dollars.
For a very young child we would make the artificial foot one or two sizes larger than the natural one; in a year or so the natural foot will reach the size of the artificial, and some months, perhaps years, will elapse before the natural foot will be perceptibly larger than the artificial. This method keeps the feet nearer the same size a longer time than would be the case if the artificial foot were made the same size as the natural foot in the first place. When it is necessary to increase the size of the foot it can be easily and inexpensively done.
When children are deprived of these useful appendages, solely from fear or apprehension that they may be outgrown, a lasting injustice is done them. There is great danger of deformity and disease from the prolonged use of crutches, particularly at a tender and susceptible age; and the most natural, easy, graceful walkers on artificial legs are those who commence the use of them in youth; the habit becomes thoroughly formed, and the continued use of them from childhood develops and strengthens the muscles and joints in a more effectual manner than can be accomplished by any other process or treatment.