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knee sockets; a composite socket for the above knee prosthesis is now being produced. This is made of nylon, epoxide resin and cork and the whole socket is formed under vacuum. More than twenty of these prosthesis have been supplied. Only two of them were considered un- satisfactory after a period of use and this appeared, in both cases, to be due to stump shrinkage after fitting. An interesting circumstance arose during the course of these experiments. Various authorities else- where stipulate that given and ideal socket shapes should be used. Hong Kong experience has been that no specific shape is suitable for all cases, the shape being dependent upon the individual. This is note- worthy and an endeavour is being made to establish this independent theory.

417. Below-knee prosthetic work has progressed and suitable pro- cedures have been evolved and improvements will be made as time permits. The development of a foot for above and below knee prosthesis has also been carried out. This foot dispenses with a mechanical ankle joint and it has been found to be economical and suitable for local use and is now made in the department.

418. The techniques of fabrication for lower extremity prosthesis have been applied to the upper extremity and well fitting and durable sockets are now made. A device has been constructed, which enables the technicians to align the wrist or elbow unit in predetermined pasi- tions, thus providing the amputee with a more efficient range of motion.

419. Standardization of some appliance parts has permitted the use of mass produced components with a consequent shortening of produc- tion time. This is being developed and eventually will extend to most items. An improvement to the ring top calipers has also been made. This is the replacement of the oval ring with a polythene weight-bearing seat designed on the principle of the above-knee prosthesis. This has proved to be most efficient and economical.

420. Work on appliances for patients suffering from leprosy has pro- gressed and a technique for taking casts which provide for a diffusion of weight-bearing has been evolved. Of the seventeen patients dealt with only one sulfered re-ulceration and it is suspected that this was due to trauma while not wearing his prosthesis.

421. Appliances for mutilated hands have also been evolved. Much of this work has been done with the co-operation of the Medical Officer in charge of Hei Ling Chau. When results are fully satisfactory it is

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hoped to extend these facilities to the outpatients at Government Leprosy Clinics.

422. The facilities of the Centre now serve the Queen Mary Hospital, the Wanchai Physiotherapy Department fully and part of the work at Lai Chi Kok Hospital, Kowloon Hospital and the Sandy Bay Con- valescent Home. Much of the appliance work at the Kowloon and Lai Chi Kok Hospitals is done by an outside contractor as is the case for the Sandy Bay and Granthum Hospitals. It was hoped to assess all #ppliances made by outside contractors prior to their referral to the surgeon, but this proved impractical for various reasons. However, the contractors were invited to the department and shown improved methods of work which have subsequently been applied. Although facilities for all Government Hospitals are not yet available, due in the main to the quantity of work and lack of facilities, it is hoped that with the addition of staff, their increasing experience and the opening of the new centre at Kowloon Hospital in 1962, this will be overcome to some extent in the ensuing year.

OCCUPATIONAL THERAPY

423. The Superintendent Occupational Therapist, assisted by a staff of Occupational Therapists and Handicraft Instructors. is responsible for providing an extensive programme of specific occupational, re- educative, diversional and recreational therapy throughout the Dopart- ment. These activities are concentrated in the institutions where there are long-stay patients, namely, the Queen Mary, Castle Peak and Lai Chi Kok Hospitals, while the Psychiatric Centre in Hong Kong provides a programme of specific occupational therapy for early psychotic and neurotic cases. A sum of $90.700 was available for the purchase of materials and miscellaneous stores and for the provision of incentive payments. Articles produced were sold by the Welfare Handicraft Shop in Kowloon and at the Annual Sale of Work and Exhibition of Occupa- tional Therapy. In addition, a number of items such as brooms and waste-paper baskets are made in quantity for the Government Stores Department. Incentive payments are made to patients in the Castle Peak Hospital and the Hong Kong Psychiatric Centre, who produce articles made for sale. This money is used to pay for entertainments such as film shows, Chinese operas, concerts and dinners. A wide range of articles is produced including paintings, rattan and wooden furniture. baskets of many types, toys, needle work, tapestry and woven articles.

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