My New Leg

I went to the prosthetics shop for my appointment last Wednesday and found this accidental history lesson leaning against the wall. The prosthesis on the right is a below-knee peg leg from the 19th century or earlier. The user would have bent his knee and rested it on the platform. The lower strap would have gone around the user’s lower thigh and knee, and the upper strap was a belt around the waist to stabilize the leg to the user’s body. The prosthesis in the middle is a post-World War Two model for an above-knee amputee. The socket is aluminum with a fiber liner inside and an articulated, wood foot. The prosthesis on the left is a contemporary below-knee suction socket with a cosmetic covering.

Looking at the peg leg on the far right, I can’t help but wonder what my life would be like had I lost my foot a couple hundred years ago — say, an ox-cart accident in 1788 instead of a motorcycle accident in 1988. It’s hard to imagine having to drag half a tree around as I clomped to the prime begging spot in the market, next to the fish monger, each morning …

On a more optimistic note, I saw Bill, a prosthetist in Wayne’s shop. I explained how the lock was clicking but, of course, the leg didn’t click now that I was at the shop. Despite his claim that he had lost much of his ability to hear high pitch sounds to too much Grateful Dead music, Bill still has a pretty sharp ear and detected another noise coming from the foot. In the photo, he is applying pressure to the foot to track down what is causing the noise.

The carbon fiber “heel” of the foot fits under a little ledge in the footshell. In my case, it fit loosely and was wiggling around inside the footshell, which caused a little squeak when I walked. Bill added a wedge of pelite around the heel to keep it locked more firmly into the footshell. One squeak down, one more click to go!

I paced around the shop and the original click came back. Apparently, taking small, light steps in the fitting room didn’t solicit the noise, but walking at normal speed in the hallway did. The click was being caused by air popping in and out of the lock and socket as I landed on my heel and lifted off my toes. So Bill glued a black leather patch over the lock…

… and packed scraps of Dacron fabric around the lock mechanism at the bottom of the socket. This photo looks into the socket and shows the fabric in the bottom. It’s not only a great example of an improvised solution to an annoying problem, but my leg is now mercifully quiet.

I should point out that this last stage in the process of getting my new leg has been remarkably and unusually easy. Often, amputees have to go through a more complex process of simply getting the socket to fit comfortably, something I think I avoided through a combination of the redundant fittings of the check socket, test socket, Wayne’s good skills as a prosthetist, and sheer dumb luck. However, it would be hard to overstate how important the stage of follow-up adjustments can be and how difficult it is to get the fit right.

If you want to learn more about this, read a detailed description of how prosthetists and amputees manage to communicate about fit and alignment in the chapter, “There’s No Language for This…”, in my Ph.D. dissertation about the prosthetics field, Performing Able-Bodiedness: amputees and prosthetics in America.