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1407 E. Michigan Ave., Jackson 517-784-1142 770 Riverside Ave., Suite 101, Adrian 517-263-3310
CHAPTER XXVII - Appliances For Deformities, Excisions, Weakened Joints, Etc.
In cases of ununited fractures of either bone of the forearm or of the elbow joint or upper arm, it is necessary to apply a brace constructed upon durable lines and capable of being removed and readjusted as conditions require. Cut W 1 shows an apparatus for an ununited fracture. The forearm and muscle parts are constructed of material sufficiently firm to serve the purpose. They are connected by articulating joints that work in harmony with the elbow, or supply the elbow motion; the parts are adjustable by lacing, they hold the bones in place and give strength and firmness to the fractured member. Cut W 2 represents an apparatus for elbow-joint resection or for dislocated shoulder joint. The forearm and muscle parts are made of suitable material and are connected by steel joints. The muscle part is provided with a hood, which rests comfortably upon the shoulder. When necessary, a strap connected with the hood is passed around the body, holding the appliance firmly in place.

Cut W 3 represents a hand mutilation, the subject being a sailor, requiring an appliance that would enable him to hold a rope, tie a knot, climb the shrouds, and carry articles about a vessel. Cut W 4 represents a socket composed of canvas, rubber, and leather, formed to fit the mutilated hand, with apertures to admit the passage of the remaining fingers; a steel, flattened hook was riveted between the apertures. Cut W 5 represents the apparatus applied, which proved to be useful and satisfactory.

There are many cases of deformities, resections, etc., of the upper extremities that can be treated practically the same as amputations. They require artificial parts that incase the weakened members and strengthen them.

Hands and parts of hands are attached to malformed members so as to correct the deformity and supply the want to a degree sufficient to make the remaining parts useful. Cut W 6 represents a deformity of the forearm, the elbow joint possessing normal conditions. This deformity case was treated as an amputation below the elbow, adjustments to meet the peculiarities of the stump. Cut W 7 represents a deformity of elbow joint and forearm, a very slight movement remaining in the elbow, the forearm terminating in an enlargement. An artificial arm, constructed similar to one for wrist-joint amputation, was made and applied.

Cuts W 8 to W 20 represent congenital deformities of the hands.

In these cases, the conditions being somewhat similar to amputations, artificial hands for partial hand amputations, as illustrated and described in Chapter XX., were applied.

Cut W 21 represents a European prince of distinguished lineage. When an infant, he fell from his nurse’s arms, paralysis of the right arm followed. As he grew to manhood, the affected member grew in length, but failed to develop in size. It was limp and useless. In 1893 he came to us, and, upon examination, we found that the entire right side of the thorax was undeveloped, and that an artificial arm could be applied without producing noticeable disproportion. The case was treated the same as a shoulder-joint amputation, and an arm constructed accordingly was attached outside the withered member. The supporting part covered a great area of the shoulder, chest, and back; this held the artificial arm in place, as shown in Cut W 22. In dressing, the withered arm was (as had always been the custom) permitted to rest close to the body, the clothing was placed between the artificial and the withered arm, and, when dressed, the prince presented an appearance that was beyond criticism, as shown in Cut W 23.

Comment from follow-up survey
Very friendly and kind, seems to truly care about the comfort of my brace.