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Limb prostheses

ACKNOWLEDGMENT: We are grateful to David and Maxine Ennis of the Repat. Museum and Chris MacLean of OPSA and prosthetist at the Repatriation General Hospital for their advice, comments and photographs.

The Oxford English Dictionary defines the word as derived from the Greek meaning “addition, to put to, or add”. It refers to surgical prostheses as “that part of surgery which consists in supplying deficiencies, as artificial limbs, teeth, or by other means”.

Artificial limbs are used to restore the function of a limb following an amputation. The first reference to a lower limb prosthesis some 3000 years ago is in the “Vedas” written in Sanskrit. It appears that Queen Fishplate lost her leg in a battle. Once the wound had healed it was replaced by an iron leg and it is said she returned to fight again.

Archaeologists have found artificial limbs in Egyptian burial sites and numerous such finds have been made in Europe before and after the birth of Christ.

Celsus about this time described the technique of amputation and vessel ligation. In the 16th Century (1510-1590), Ambrose Paré realised the life saving potential of amputation of a gangrenous limb and began developing prosthetic limbs.

The attempts to use atmospheric pressure to aid the attachment of a prosthesis to a limb dates to the 18 th. century. Most recent advances date from the Second World War. In the 1940s the suction sock was developed and in 1975 M. Martinez attempted to use heel springs and joints in order to improve mobility to near normal. Some centres use immediate post operative prostheses which are later replaced by the current models. The advances in technology and the development of plastics have resulted in further improvements.

In the past, war and other trauma, infection and congenital deformities were the major causes of amputation. The current causes of amputation are usually due to peripheral vascular disease, trauma or malignancy.

Not so long ago bone setters, splint and brace makers were active in trauma management and rehabilitation. The current appellation refers to Orthopaedic Surgeons and Orthotists.

In Adelaide the major Orthotic centre is at the Repatriation General Hospital which cares for the WW2 amputees and some of the early post WW2 prostheses are in the “ Repat Museum ” which is on the campus of the Hospital.

Lower limb prosthesis to fit Syme ("at the ankle") amputation stump. It was made by a WW1 veteran living in the country and unable to attend a major city hospital.


End-on view of the prosthesis showing the patella notch, a wider area for the hamstrings and end bearing area for the Syme stump.


A child’s peg prosthesis for an above knee amputation.


End and side view of a primitive below knee prosthesis with side extension for support (mid 1960s)


An above knee exoskeletal prosthesis showing a pelvic belt with a single axis knee joint and a solid ankle cushion heel (Sach.)


An upper limb prosthesis for an above amputee, showing the shoulder socket and brace, elbow joint and a hook.

A closer view of the prosthesis: The elbow can be locked in various positions (above right) the hook can be rotated, the control cable and lever for operating the hook (below).


Recent below knee plastic laminated prosthesis. the pylon is carbon fibre and the foot is a flex foot.


Two additional views which show the silicon liner which fits over the stump and the attachment pin at the lower end, which fits into the shuttle lock system of the stump (left.) The pylon is made of carbon fibre and the flex foot (right.)



Two views of a “thigh corset”. above knee prosthesis. The lacing holds the stump firmly in place. The knee can be flexed when sitting.


Another above knee prosthesis with a pelvic belt and a single axis knee joint which allows flexion for sitting and walking.



Attachment points are visible. The foot is a flax foot and the stump socket is shown in the lower photograph.