You're using an outdated browser and can not see this website's design. We've allowed you to access all the content however, so you're not missing anything other than the pretty wrapper. Please download any browser that supports standards to view the full site.
1407 E. Michigan Ave., Jackson 517-784-1142 770 Riverside Ave., Suite 101, Adrian 517-263-3310
CHAPTER XV - Home Measurements
Our system, devised and inaugurated years ago, by which measurements and diagrams for artificial limbs can be taken at home by the family physician or the subject himself, assisted by some member of his family, and our method of fitting and constructing artificial limbs from such data, have proved so satisfactory that we encourage those desirous of saving long, tedious, and expensive journeys to have their limbs made from measurements while they remain at home.

This feature has placed our facilities and skill within reach of those who are in need of artificial limbs, no matter how distant they may reside from us; it affords an opportunity to obtain the best at the least possible expense and trouble.

So successful have been the results obtained from this method that expressions of gratitude and commendation have come from the most distant parts of the world. Men of prominence, as well as those not so frequently in the public mind, have benefited by the plan.

We have customers living within a few miles of New York City who are so actively engaged that they prefer to have their limbs fitted from measurements under the guarantees we give, rather than absent themselves from their homes.

To encourage persons to have their limbs made in this way, we agree to make all changes or reconstructions without charge, whether such are required on account of errors in measurements or changes in stumps, or any other cause whatever.

If anyone desires to be present at the fitting, we will not dissuade him from his intentions, and will give him immediate attention on his arrival.

As soon as measurements and diagrams are received, we subject them to the closest scrutiny, and if errors or omissions are discovered, they are returned for corrections, and if there are any indications that successful fittings from measurements are doubtful we do not hesitate in notifying the party to that effect. As soon as we accept the data we assume all risks, we make the leg accordingly and forward it to the client with full instructions for its application. Should it fail to fit properly, it can be returned with particulars, and we will alter or reconstruct it without charge.

INSTRUCTIONS WHEN ONE LEG IS AMPUTATED

DIAGRAMS. - First, make a diagram of both the sound and the amputated legs. This is done by removing the clothing and sitting on a large sheet of paper, with both the sound leg and the stump extended and slightly spread apart, the foot pointed directly upward. Beginning at the body, draw a pencil down the outside of the sound leg from the hip, around the heel and up the inner side to the body. Then carry the pencil down the inner surface of the stump and around the outer side to the hip.

Cuts N 1 and N 2 show the manner in which this is done if the amputation is below the knee; Cuts N 3 and N 4 show the same if the amputation is in or above the knee. For side diagrams, it is necessary for the patient to lie on one side with the knee bent at right angles and then pass the pencil around the leg, as shown in Cut N 5.

If the amputation is below the knee, turn on the amputated side, resting the exterior surface of the stump and thigh on the paper, and mark around it, as shown in Cut N 6. Then, without changing the position of the body, flex the knee to about right angles, and mark around the thigh and stump, as illustrated in Cut N 7.

These diagrams will show the amputated leg in two positions, one with the stump fully extended, and the other flexed at right angles. If there is a limited motion in the knee joint, special care must be taken that the limits of extension and flexion are shown in the diagrams.

Then place the foot on the paper and draw a line around it, as shown in Cut N 8.

MEASUREMENTS. - After the diagrams come dimensions. Measuring should be done in the morning when the stump is not swollen; a tape line should be used. Begin with measuring the distance from the crotch, or perineum, to the floor - the end of the tape line must be put close to the body between the legs and carried vertically down to the floor (see Cut N 9); in the same way measure the distance from the crotch to the end of the stump (see Cuts N 10 and N 11). Measure from the end of the stump to the floor, as shown in Cut N 12 or N 13.

While still standing take the circumferences of the sound thigh, beginning close to the body, as shown in Cut N 14, repeat at points two inches apart, until the knee is reached, then take the circumference of the knee around the knee-cap, then the following circumferences; the leg immediately below the knee-cap, the calf, smallest part of the ankle, just above the joint, the heel and instep, the instep, the foot at the base of the toes; then measure the length of the foot.

If the amputation is below the knee, take the circumference of the thigh close to the body (see Cut N 15) and repeat these circumferences at points two inches apart until the entire thigh is measured; then take the circumference of the knee around the knee-cap; then take the circumferences of the stump, beginning immediately below the knee-cap, and repeating at points two inches apart until the entire stump is measured. If the amputation is in or above the knee, take the circumference close to the body and repeat at points two inches apart until the entire stump is measured.

After the circumferences have been taken, measure the distance from the top of the knee of the sound leg to the floor when seated in a chair, with the leg bent at right angles (see Cut N 16). Write all these lengths and circumferences on the diagrams in their respective places.

If correctly made, the diagrams of an amputation below the knee will resemble those figured in Cuts N 17 to N 20; for amputation in or above the knee they will resemble Cuts N 21 to N 24.

Other required measurements include the height of the person when standing erect on the sound leg. This can be taken by standing against a wall and the height marked by a book or carpenter’s square (see Cut N 25); the distance from that point to the floor should then be carefully measured; then sit on the bare floor, with the back against the wall, and note the height from the top of the head to the floor, as shown in Cut N 26.

These heights are wanted to verify the length given of the leg. The height from the head to the floor when sitting subtracted from the height when standing is equal to the length of the leg.

INSTRUCTIONS WHEN BOTH LEGS ARE AMPUTATED

If both legs are amputated, either above or below the knees, or if one is amputated below and the other above, it is necessary to make diagrams of each stump and thigh, presenting both front and side views, with knee joint extended and flexed to as near right angles as possible. These can be taken by disrobing and sitting on a piece of paper with the stumps extended and marking around them from body to the ends with a pencil held perpendicularly (see Cut N 27). Then turn to one side so that the exterior surfaces of the thigh and stump will rest on the paper; the stump extended, mark around the thigh and stump, then bend the knee to about right angles and mark around thigh and stump (see Cut N 28). A similar diagram must be made of the other thigh and stump (see Cut N 29). After these diagrams have been made, circumferences should be taken by passing a tape line around each thigh, close to the body, and repeating at points of about two inches apart until the thighs and stumps have been measured. Care should be given to take the measurements when the stumps are not swollen and to draw the tape line moderately tight, as shown in Cuts N 30 and N 31. Write all the measurements in plain figures in their respective places on the diagrams. Sit on the floor, with back against the wall, and mark, by book or square, the distance from the top of the head to the floor, as illustrated in Cut N 32. Send this measurement, together with former height, that is, the height before amputation. If the full former height is to be restored that fact should be noted.

Stumps that reach to the ankle joints or knee joints should be reproduced in plaster.

The following questions should be answered in every case: Name of patient? Post-office address? Occupation? Age? Weight? Cause of amputation? When was the amputation performed? Which leg amputated? Has an artificial leg been worn? For how long? Name of the party ordering the leg? His address? Is the leg to be made and fitted from measurements in the absence of the patient?

If it is proposed to take weight on the end of the stump, that fact should be noted.

If the amputation is in the ankle joint or in the foot, the diagrams and measurements are the same as are required in amputations above the ankles.

PLASTER CASTS. - Plaster casts are only required of stumps that reach to the articulations (knee or ankle joints) or in the feet, and of deformed limbs, and of amputations that have resulted from deformities.

The method of making a plaster cast depends upon the condition of the stump. For tapering stumps, the following is the simplest: Remove the clothing, shave all hair from the stump or fasten it down with past, or thick soap, as otherwise it will cling to the plaster. Then take two quarts of thick, quick-drying plaster of Paris, such as used by dentists, put a quart of water in a bowl and sprinkle the dry plaster in it, mix thoroughly. It should be made about as stiff as “pancake dough;” then spread it over all sides of the stump to the thickness of at least half an inch. The stump must be held perfectly still until the plaster has become hard, which will be about ten minutes. Then draw it from the stump and the inside will be a counterpart of the stump.

If the stump is larger at the end than immediately above, as in the case of partial foot, ankle-joint, or knee-joint amputations, the plaster must be broken off in large pieces and put together after the stump is removed, or the string method can be used, as follows: A piece of strong, thin cord is passed loosely up each side of the limb (see Cut N 33), to which it is made to adhere by thick plaster (see Cut N 34). Work quickly, using about four quarts of slacked plaster and cover the entire limb to a thickness of not less than half an inch. As the leg must be held vertically, the plaster must be quite thick, otherwise it will flow down. Every part, the back, sides, front, and end, must be liberally covered. As soon as the plaster has become a little set, the string can be pulled gently downward (see Cut N 35), cutting the mold into longitudinal parts. It must now be left alone, so as to thoroughly harden, which will take about ten minutes; the mold can then be separated on the line cut by the string and the two parts removed (see Cut N 36). These parts can then be greased or oiled on the inside and put together and bound with string; the inside can then be filled with thin plaster of Paris (see Cut N 37). When the mold is filled, it should be laid aside for several hours, when it will have become so hard that the shell will yield to slight pressure and break off, uncovering a facsimile of the stump.

The plaster bandage method is an excellent way of taking a cast of a flabby and tapering stump. A sheet of old muslin or cheesecloth is cut into strips about two inches wide and sewed into lengths of about twelve feet long. Three such strips are usually needed. Dry plaster should be spread on the strips which are then rolled up very tightly (see Cut N 38). No more plaster should be put on than will fill the meshes. The stump should be prepared by removing the hair or fastening it down with paste or thick soap. The plaster bandage roll must be immersed in water and allowed to remain until the bubbles cease to come to the surface (see Cut N 39). It is then taken from the water and wrapped around the stump while being unrolled, beginning at the end of the stump and continuing to a little above the knee (see Cut N 40), then work down and up again, covering the stump with three or more layers or until all the bandages have been used. Allow the bandage to remain on the stump until it becomes hard, when the stump can be withdrawn (see Cut N 41). The plaster bandage will form a mold of the stump, which can be sent to us as it is, or it can be greased and filled with slacked plaster, and a true cast made, as previously described.

Casts and molds should be sent packed in sawdust to prevent breakage. If shells are sent, they must be filled with sawdust, to prevent collapse in transit.

Comment from follow-up survey
The whole staff was wonderful, caring people I cannot say enough about these wonderful people.