. A treatise on artificial limbs with rubber hands and feet ... n the interior, anterior, and posterior surfacesimmediately below the knee. The styloid process of the fibula isalways close to the surface and is surrounded by sensitive tissue andis painful to continuous pressure; therefore, the exterior surface mustnever be permitted to bear pressure. Tibial stumps that are well covered with periosteal and integu-mentary tissue can receive pressure on their ends, but these stumps areextremely few. A thigh stump will never admit of weight being applied to its A. A. MARKS, ARTIFICIAL LIMBS, NEW Y
. A treatise on artificial limbs with rubber hands and feet ... n the interior, anterior, and posterior surfacesimmediately below the knee. The styloid process of the fibula isalways close to the surface and is surrounded by sensitive tissue andis painful to continuous pressure; therefore, the exterior surface mustnever be permitted to bear pressure. Tibial stumps that are well covered with periosteal and integu-mentary tissue can receive pressure on their ends, but these stumps areextremely few. A thigh stump will never admit of weight being applied to its A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. 345 extremity, unless the end of the femur is covered with a periosteal flapand that in turn well covered and protected by an integumentary flapwith the cicatrix well removed. An artificial leg applied to a thigh stump takes weight about theischial and perineal regions, where the gluteal folds provide naturalcushions. Cut No. 1176 represents a thigh stump. It is held horizontally inorder to show the mobility of the hip. The flap, as will be seen, is. No. 1177. well carried to the rear and the extremity is well protected. This isa model short thigh stump; it can be depended upon to perform a vastamount of labor. Cut No. 1177 represents a short thigh stump, circu-lar operation, with tissues adhered to the bone. The stump is coveredwith accommodating folds that permit displacement without pressureon the cicatrized end. Sinuses.—Sinuses in the ends of stumps are sometimes the cause ofanxiety, as they are stubborn to heal and frequently rebel against treat-ment. It is an error to assume that their presence prevents the wearingof an artificial limb. While we always condemn the premature appli-cation of an artificial leg, we have found when a stump is healedwith the exception of a sinus, that the wearing of an artificial limb 346 A. A. MARKS, ARTIFICIAL LIMBS, NEW YORK CITY. stimulates the circulation, and is frequently the means of causing thesinus to heal. The end of a t
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