History of The Prosthetic Leg Through The Ages
Throughout history, there have been those who sought to help those affected by limb loss so they could live fuller lives.
The history of prosthetics began before the advent of writing, and that’s based on only a few fragments we’ve been able to uncover. Over time, advances allowed for the replacement of a simple wood or iron artificial leg with sophisticated devices that came closer to mimicking biological function.
Advances we appreciate in modern prosthetics would not be possible without the pioneers who came before. This post celebrates the evolution of the prosthetic leg from ancient human history right up to the modern day.
Prosthetic Legs of Ancient History
We don’t have many surviving examples of prosthetic legs from ancient times. Many of them would have been made out of perishable materials, and the mortality rate for leg amputations in ancient times was staggeringly high.
However, what scraps we do have show that desire to restore form and function to the human body was shared by our earliest ancestors.
Artificial Legs in Writings and Myth
Being able to effectively replace a missing part of the body has always captured the imagination.
The Aztec god of creation and revenge, Tezcatlipoca, lost his foot in battle with the Earth Monster. He is depicted with a replacement foot made out of obsidian.
An epic Indian poem dated between 3500 and 1800 B.C. entitled the Rigveda features a warrior queen named Vishpala. When she loses her leg in battle, she is given an artificial leg of iron.
A written record by the Greek historian Herodotus from 424 B.C. wrote of a Persian prisoner of war who amputated his own leg to escape. He was able to fashion an artificial leg out of wood and walk 30 miles before being recaptured.
The religion of ancient Egypt emphasized wholeness, and it was believed that a missing limb would continue to affect the deceased in the afterlife. Egyptian artificial limbs were made out of fiber and designed to help replace form more than function.
While no functional prosthetic legs have been uncovered from this time, we do have examples of prosthetic toes. The big toe of the foot is not only required for balance but would have been necessary to wear traditional Egyptian sandals.
A wood and leather toe designed for a noblewoman dubbed The Cario Toe dates from 1069 to 664 B.C.
The Grenville Chester Toe is another example, dating between 1295 to 664 B.C. It was made out of a paper mache-like material of linen, glue, and plaster.
The Capua Leg
The oldest surviving leg prosthesis was uncovered in Capua, Italy and dates back to 300 B.C. It was discovered in a tomb with the remains of its wearer and shows signs of frequent use. This lower-leg prosthesis would have been attached to the body with a waistband of sheet metal.
Horse-Hoofed Prosthetic Leg From China
A prosthetic leg made of poplar wood with a horse hoof for a foot was discovered in a tomb in China. It dates back to around the same time as the Capua Leg and was found with the remains of its wearer who had a deformed knee. The prosthetic was attached to his affected legs with leather straps and allowed the user to walk and ride a horse.
The Middle Ages 500 – 1500 A.D
Prostheses did not see much advancement in this era of human history. A prosthesis could only be afforded by the wealthy, or otherwise created out of whatever materials were at hand.
Amputation procedures at this time were still primitive, and often performed by a barber or a ship’s cook. A pegleg was a common replacement for survivors of war or battle. Scrap wood was easy to come by and could be fashioned into an artificial leg by any tradesman or armorer.
Knights who lost limbs could be fitted with iron artificial legs that would allow them to ride their horse, but otherwise provide little function.
Ambroise Paré (1510 – 1590): Father of the Modern Prosthetic Leg
Ambroise Paré was an accomplished barber/surgeon and anatomist who was the official royal surgeon for four French kings. He is regarded by many as the father of modern surgery.
Along with improving amputation techniques and survival rates during his time as a war surgeon, he developed functional prosthetic limbs for all parts of the body. He used his understanding of anatomy to design prosthetics that mimic the function of biological limbs.
He was the first to develop an above-knee prosthetic with an adjustable harness and a hinge-knee with lock control – both of which are still used today. He also transitioned away from wood in favor of much lighter prosthetics made of leather, paper, and glue.
Prosthetic Legs of the 17th Through 19th Centuries
Paré’s advances opened up new thinking for amputation and prosthetics. Inventors would continue to advance the science of the prosthetic limb continually leading up to the modern day.
Pieter Verduyn was a Dutch surgeon who in 1696 invented a nonlocking below-knee prosthetic. This device had external hinges and a leather thigh socket, which is similar in form and function to modern corset prosthetics.
Londoner James Potts invented an above-knee prosthetic in 1800 with a calf and thigh socket made of wood, and a flexible foot attached with catgut tendons to a steel knee joint. This design was not only more articulate than precious prosthetics but was considered more aesthetically pleasing.
This design emigrated to the U.S. in 1839 and was the standard leading up to the U.S. Civil War.
Prosthetic Legs of The American Civil War
The American Civil War raged from 1861 to 1865, and the demand for prosthetics rose astronomically. This need ushered in an era of rapid growth in prosthetic leg technology in The United States with over 80 patents for prosthetic legs filed between 1861 and 1873.
J.E. Hanger and The Hanger Limb
James Edward Hanger (1843 – 1919) was an American engineer who was the first amputee of The Civil War. He spent his convalescence designing a prosthetic leg, and would go on to patent his “Hanger Limb” and found the company that became Hanger Inc.
His original Hanger Limb was fashioned out of oak barrel staves and had articulated knee and ankle joints for better mobility.
The Salem Leg Company
The Salem Leg Company produced articulated above-knee prosthetics and below knee prosthetics. They were officially recommended by the U.S. government for the army and their sales materials included testimonials from prominent war veterans.
This description from their sales pamphlet provides insight into the prosthetic technology of the day:
“The inventor of this leg having learned, from painful experience, that wood – the material commonly used for sockets – was entirely unsuitable for his case, determined to select such materials, not merely for the socket but for every part of the leg, as were best adapted to secure the ends in view, namely comfort, strength, durability, convenience, economy and elegance. Accordingly, the Salem Leg is NOT a wooden leg. It has two sockets, one of yielding material, which is shaped over a cast of the stump, and another of sheet metal, which serves as a light, firm, yet slightly elastic case for the soft socket. The exterior, or metallic socket, is mounted on steel supporters, which, uniting at a suitable distance below the stump, are connected with a screw proceeding from the joint. The joints are of steel, and are so constructed as to secure steadiness, smoothness and silence of action. The action at the joints is limited by shoulders and cushions, all cords being dispensed with. The shaping up of the leg is done with hair and other suitable materials; and the covering is of flesh-colored leather, so attached that it can be removed or replaced with little inconvenience or expense. The whole leg is put together that it may be taken apart, readjusted and reconstructed, with the utmost facility.”
Dubois L. Parmelee
A major advancement in leg prosthetic sockets was made by New York inventor Dubois Parmelee in 1863. His socket attached to the residual limb using atmospheric pressure, and india rubber was used to comfortably adjust to a patient’s residual limb.
The World Wars necessitated new advancements in prosthetic technology.
After World War I, the Surgeon General of the U.S. Army got the ball rolling on what would become the American Prosthetics and Orthotics Association. Despite this, there were no major advancements in prosthetics till post-World War II when the U.S. government provided funding to military companies to improve the form and function of prosthetics. This led to many of the modern materials used in prosthetics such as plastic, aluminum, and other composite materials.
Also noteworthy was the invention of the suction sock for above-knee prosthetics at UC Berkeley in 1946.
Ysidro M. Martinez
In 1975, Mexican American inventor Ysidro M. Martinez invented a below-knee prosthetic to help improve gait problems associated with prosthetics of the time. His design had a high center of mass and was lightweight to reduce friction and pressure and allow for acceleration and deceleration.
Today and Ahead
Thanks to the passion of prosthetic pioneers, today we are closer than ever to replicating the full function of a biological limb.
Blade prostheses allow amputee athletes to sprint. Microprocessor knees allow a prosthetic to adapt its flexion and extension for different environments. 3D printed prosthetics have sparked a renaissance of cost-effective DIY prosthetic design and production.
With the advancement of neuroprosthetics and fully-realized brain-controlled devices, we have never been closer to the dream of fully replacing a missing limb.
Image: Science Museum Group