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1407 E. Michigan Ave., Jackson 517-784-1142 770 Riverside Ave., Suite 101, Adrian 517-263-3310
CHAPTER VI - Knee-Bearing Stumps
DEFINITION. - When the knee joints of tibial stumps are contracted at right angles, or when the stumps are so short that they are unable to control the artificial knee joint, they are termed knee-bearing stumps, and require artificial legs constructed to receive them in flexed positions.

It is sometimes problematical to determine whether a stump should be placed in this class or in the class requiring legs constructed on the plan of E 17. The conditions to be considered in deciding the question are as follows: First, anchylosis or immobility of the knee joint when flexed. Second, length of the stump projecting back of the thigh when at right angles. If this is less than two inches the knee-bearing leg must be selected. Third, remediless contractions of the flexors, limiting the angular range of motion to one-half the normal range, no matter how long the stump may be. Cuts F 1 to F 4 show typical knee-bearing stumps.

KNEE-BEARING LEGS. - Cut F 5 shows a leg suitable for stumps of above character. The socket and leg part are made of wood covered with rawhide and enameled. The socket is excavated to receive the stump and thigh in a comfortable way, and the part from the knee down is hollowed out to reduce the weight. The exterior dimensions are as close to those of the natural leg as conditions will admit. The foot is of rubber with spring mattress as previously described.

BOLT JOINT. - Cut F 6 shows the knee mechanism with the parts separated: a is the knee-bolt which holds the leg and thigh sections together, forming an axis for the knee. It is flanged on one end and threaded on the other. When the bolt is passing through the metal ear which is riveted to the lower leg the head sinks into its bed and the threaded end screws into the ear riveted to the opposite side. The set screw b, placed into the flanged end, prevents the bolt from moving and working out; c is the check cord screw; d the check cord; g the spring piston; h the spiral spring; i the cylinder. The relations and functions of these parts can be understood from an examination of Cuts F 7 and F 8, which show the leg with the knee extended and fully flexed.

The action of the spring holds the leg at flexion when the wearer is seated, and urges the leg forward when walking. The range of articulation can be regulated by means of pads placed between the lower end of the check cord and the bridge under which it passes. These pads can be reached through the opening in the calf of the leg. The upper loops of the check cord rest in their respective channels and through them a steel screw is passed and set.

The mechanism of the knee-bearing leg is very durable, and will stand severe use for years.

SIDE JOINT. - The center of motion being placed below the natural knee, causes a disparity in the lengths of the two thighs; only noticeable, however, when the wearer is seated and subjected to close scrutiny. The durability of the knee-joint mechanism in style of leg shown in Cut F 5 fully compensates for excessive length of thigh, moreover, this mechanism admits of the minimum width of the knee. The choice of style remains with the wearer; if he prefers the wide knee to the long thigh, and is willing to sacrifice durability, he can have the leg constructed with side joints, as represented in Cut F 9, the center of knee motion of which is brought to the sides of the knee by means of hinge joints, of the style shown in Cut E 23, page 52. The knee-check cord is practically the same as that represented in Cut F 6. Cut F 10 shows the leg applied, wearer seated with knees flexed.

PEG LEGS. - Peg legs for knee-bearing stumps are of three kinds; and will be considered in their order: Cut F 11 shows the cheapest form of peg leg for a knee-bearing stump; its construction is of bent wood with metal ferrule, rubber tips, and leather strappings. Cut F 12 shows a peg leg with knee joint suitable for a knee-bearing stump.

Cut F 13 shows a peg leg without knee articulation for knee-bearing stump. The upper parts, F 12 and F 13, made of wood and leather, fitted to receive the stump, which is held in place by lacing.

The ends of peg legs are terminated by metal ferrules and rubber tips as described in Cuts E 57, E 58, and E 59, page 71.

INCOMPLETE RESTORATIVES. - For reasons heretofore given, we do not advocate peg legs for knee-bearing stumps and only furnish them when they are especially ordered. It is far better for a person to procure a complete artificial leg with rubber foot, with spring mattress, one that will possess all the elements necessary for helpful and convenient walking, even if he has to deny himself in other ways in order to obtain one. A peg leg is makeshift, and will in all probability weaken or destroy what knee motion remains.

SUSPENDERS. - Suspenders suitable for knee-bearing legs are substantially the same as those employed for tibial stump legs. The details are given in the preceding chapter.

I have been an amputee for 15 years. I have met many people who tried to fit me with a leg and Ted is the best I have ever gone to. Anyone anywhere in the country should seek this company out for their prosthesis because they are simply the best.

T.J. Cottrell