Leg (support)

“ Where the leg, for instance, has been lost, they feel as if the foot was present, but as though the leg were shortened. If the thigh has been taken off, there seems to them to be a foot at the knee; if the arm, a hand seems to be at the elbow, or attached to the stump itself. ”

“ There may be a feeling of weight in the limb, and in the case of the knee and ankle the patient tires on walking and drags the leg with more or less of a limp. Movements of the joint are permitted, but are limited in range. ”

“ This lunge will do for every cut and every point.
To recover after a lunge, throw your weight well back upon your left leg, and use the muscles of the right thigh and calf to shoot yourself back into position. If the knee of the right leg has been kept exactly over the ankle, the impetus necessary to regain your original position will be easily obtained. If, however, the right foot has been protruded too far, and the caution as to the knee and ankle disregarded, you will find yourself unable to return quickly from the lunging position, and will consequently be at your opponent’s mercy. ”

“ With the patient on his back, the leg having been straightened and any deformity removed as far as possible by grasping the foot and pulling directly away from the body while an assistant steadies the thigh, a large, soft pillow, inclosed in a pillowcase, is placed under the leg. ”

“ The bones of the column meet and form articulations that are held together by ligaments, and attached to their faces, borders and extremities are muscles and tendons. In the superior portion of the limb the muscles are heavy, tapering inferiorly, and terminating in the region of the foot in long tendons. Each limb is divided into four regions. The regions of the fore-limb are the shoulder, arm, forearm and forefoot. In the hind limb are the regions of the pelvis, haunch, thigh, leg and hind-foot. ”

“ The foot being fixed in the equinus position the patient must wear boots while the examination is being carried out.
B. Mechanism of walking.—In walking, a step being taken with the artificial leg, the toe of the foot is the last to leave the ground, the heel being raised and the knee straight. The limb is swung forward and raised by flexion of the hip: active flexion of the knee is impossible, but passive flexion occurs, owing to the weight of the leg piece, as the thigh is raised. ”

“ For a leg hanging like a flail, or shortened by some inches, is not so good for purposes of locomotion as a wooden leg is, while an arm, even though powerless at the elbow, and perhaps much shortened, can be so strengthened and supported by slings and bandages as to give a most useful hand, the complex movements and uses of the fingers of which no mechanism can at all imitate. ”

“ At first the limbs are of almost no use in locomotion, but the fundamental trunk muscles with those that move the large joints are more or less spasmodically active. Then comes creeping, with use of the hip muscles, while all below the knee is useless, as also are the fingers. Slowly the leg and foot are degraded to locomotion, slowly the great toe becomes more limited in its action, the thumb increases in flexibility and strength of opposition, and the fingers grow more mobile and controllable. ”

“ On the contrary, if the leg is placed only slightly forward with but little flexion of the knee, as explained in the detailed description, the upper body has to be bent further downward in order that the hands reach the lower leg at the ankle. ”

“ Experiment 29. To show the ligamentous action of the muscles. Standing with the back fixed against a wall to steady the pelvis, the knee can be flexed so as to almost touch the abdomen. Take the same position and keep the knee rigid. When the heel has been but slightly raised a sharp pain in the back of the thigh follows any effort to carry it higher. Flexion of the leg to a right angle, increases the distance from the lines of insertion on the pelvic bones to the tuberosities of the tibia by two or three inches—an amount of stretching these muscle cannot undergo. ”

“ We do not use our own limbs other than as machines; and a leg is only a much better wooden leg than any one can manufacture.
“Observe a man digging with a spade; his right fore-arm has become artificially lengthened, and his hand has become a joint. The handle of the spade is like the knob at the end of the humerus ”

“ Treatment.—By the end of three weeks in favorable cases there may be some motion obtained by the patient in the limb which was paralyzed, or there may be evidence of threatened deformity. It is at this time and in the weeks and months to follow that so much depends upon treatment. The muscles of a leg or arm may waste away so as to make them useless if not promptly cared for. If contractions of muscles are not prevented, a club-foot, toe-drop, or some similar deformity may develop. ”

“ For a Broken Thigh, Upper Leg.—The splint should extend from under the arm to the ankle, padded and bound to the body and to the leg by means of long towels or pieces of sheeting applied six inches apart. If the patient is in a wagon and no splint can be had, bags of dirt or sand applied around the thigh will hold some. ”

“ To the lunge of the left foot add an equally full and direct and fast lunge of the left shoulder, elbow, and wrist. Your head should come forward also, above your left foot. Imagine yourself to be aiming at a ball, and see that your left wrist is in a line between your eyes and some object, say a chair’s leg in the bedroom. ”

“ On the other hand, the femur is united, as with us, to a massive pelvis; the articular surfaces of the knee, the knee-pan, and the two immovable bones of the leg, are just what the exclusive function of locomotion requires; the foot is plantigrade, with a prominent heel and close toes, and is articulated perpendicularly by its arch with the leg, as in man. ”

“ Grasp the right ankle by the right hand, and, standing on the left leg, bend it until the right knee touches the floor, then rise slowly to a standing position again. The left hand must be kept extended all the time and must touch nothing. ”

“ If it were supported on lax and flexible legs, its joints would constantly give way, equally incapable of supporting its weight, should it wish either to kneel or rise. But it has under the foot a little ankle joint which takes the place of the leg and knee joints whose mobility would never have resisted this enormous and swaying mass. ”

“ Lie flat on your back on a bed or, better still, a mat on the floor, hands under head. Without bending knees, raise the right leg as high as possible and lower it slowly. Repeat a number of times, then raise the other leg, then alternate. ”

“ When fatigued with long standing it naturally rests itself on this side, the weight falling on the right foot, which loses its arched form and becomes elongated, while the length of the limb is sensibly diminished. I have seen cases in which the right leg has become much shorter than the left, entirely from persistence in this inelegant habit. A short time ago a child was brought to me whose foot was quite flattened, every vestige of its arches having been destroyed ”

“ It can be practised by a man whose leg has been amputated, preferably the right leg, for the resting point, in handling the plane, is on the left leg. However, we cannot forget that one-armed men have achieved wonderful results. ”

“ The large or apparently Sweled legs particularly observable in the women, are obtained in a great measure by tying a cord tight around the leg above the ancle bone. their method of Squating or resting themselves on their hams which they Seam from habit to prefer to Setting, no doubt contributes much to this deformity of the legs by preventing free circulation of the blood. ”

“ But perhaps the most absolutely distinctive character about the muscles of the foot is the existence of what is termed the 'peronaeus longus', a long muscle fixed to the outer bone of the leg, and sending its tendon to the outer ankle, behind and below which it passes, and then crosses the foot obliquely to be attached to the base of the great toe. ”

“ A Loose Cartilage, or a Displaced Cartilage in the Knee Joint is apt to become caught in the hinge between the thigh bone and the leg bone, and by causing a sudden stretching of the ligaments of the joint to give rise to intense pain. ”

“ Rich bent the leg on the thigh, so as to relax the muscles in the calf of the leg as much as possible, then with his hands worked down the calf, bringing the upper end of the tendon down, and put a bandage around to confine the muscles and keep them from retracting ”

“ At the psychologic moment the right foot is advanced half a pace, the left leg straightened into a brace, the right arm, with its extended cutlass, stiffened to a bar of steel—and the thing is done. The keen two-foot blade, slipping between the shoulder blade and the first rib, shores its way through heart and lungs, and its point may even penetrate to the abdominal cavity. ”

“ When the leg is thus slung, the knee will be somewhat bent, the thigh raised, the muscles of the leg behind relaxed, and the patient can be moved with much greater facility than with any other apparatus; one great advantage of this apparatus is, that it can be used with effect even if the patient be obliged to lie on the ground. ”

“ The most common defect in standing is that the entire weight is usually borne upon the same leg, generally the right one, while the left, being inactive, is placed out to one side; the habitual maintenance of this position leads, as we shall see later, to a tilting of the pelvis to one side, with a consequent spinal curvature and lowering of one shoulder.
Persons with strong feet, especially primitive unshod feet, mountaineers, runners, and young children, walk [Pg 341] with the inner borders of the feet nearly parallel to each other and the direction of motion. ”

“ Then, the man being laid on the sound side, we bring the sound leg between the posts, underneath the piece of wood corresponding to the step of a ladder, while the injured one is brought above it, so that the head of the thigh is upon it; but a folded garment is to be first wrapped about it to prevent the thigh from being bruised. Then another board of moderate breadth and of such a length as to extend from the head of the thigh to the ankle, is to be bound along the inner side of the thigh to the ankle. ”

“ His back ain't hurt serious, but his left leg and his right arm are both broken and he's an awful lot cut and bruised, especially about the back and the head. I can set a leg myself, as good as most, and many a one have I done, but those that I've set 'em for don't always seem to have as good use of their limbs after as before. ”

“ Leg exercises are useful for purposes of relieving the engorged veins of the fatigued leg, because the movements of such large masses of muscles as those of the legs and thighs demand large supplies of blood, and consequent quick action on the part of the heart to supply it, and this blood, pouring swiftly back to the lungs for purification, requires frequent and deeper inspirations on their part to effect the purification; leg exercises cause greater development of the chest than do arm exercises. ”

“ Unbuckling the leg at night on going to bed, and having to hop about or use a crutch when the leg is off. Putting on the leg in the morning. In sitting down, always some consideration as to how the leg is to be adjusted. Going up and down stairs, the real leg first at every step, and the artificial leg brought up behind it. ”

“ This joint is formed by a polished glass ball plying in a socket of vulcanite, the foot and ankle being joined together with four tendons, passing through rubber springs in the ankle; this joint admits of every motion the natural ankle has. In walking on the side of a hill or inclined plane, or where the foot is used to brace the body, the ankle flexes laterally and the foot remains flat on the ground, thus giving a firm base of support. ”

“ SECTION III. LAMENESS IN THE FORE LEG. Anatomo-Physiological Review of parts of the Fore Leg.
For supporting weight, whether the subject is at rest or in motion, the bony column of the leg, together with attached ligaments, tendons and muscles, is wonderfully well adapted by nature for the function which they perform. The several bones which go to make up the supportive portion of the leg, are so joined at their points of articulation, that a minimum degree of strain is put upon each attachment. ”