Crutches

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Introduction

Crutches are a type of Walking Aids that serve to increase the size of an individuals Base of support. It transfers weight from the legs to the upper body and is often used by people who cannot use their legs to support their weight (ie short-term injuries to lifelong disabilities).

Crutch Type

There are three types of crutches; Axilla crutches, Elbow crutches and Gutter crutches.

• Axilla or underarm crutches They should actually be positioned about 5 cm below the axilla with the elbow flexed 15 degrees, approximately. The design includes an axilla bar, a handpiece and double uprights joined distally by a single leg. They are adjustable in height, both the overall height and handgrip height can be adjusted (adjustable approximately 48 to 60 inches (12 to 153 cm).
• Forearm crutches (or lofstrand, elbow or Canadian crutches). Their design includes a single upright, a forearm cuff and a handgrip. The height of the forearm crutches are indicated from handgrip to the floor (adjustable from 29 to 35 inches or 74 to 89 cm).
• Gutter Crutches (or adjustable arthritic crutches, forearm support crutches) These are additional types of crutches, which is composed of padded forearm support made up of metal, a strap and adjustable handpiece with a rubber ferrule. These crutches are used for patients who are on partial weight bearing like Rheumatoid disease.

 

Measurement

It is essential that crutches are measured and adjusted to suit every patient they are given to. While the incidence of adverse events related to crutch use is low, series medical complications can occur. Adjusting the device to fit the user may reduce adverse events. There are various methods to measure both the canes.

Walking Pattern

There are several different walking patterns that an individual using crutches may use, including:

• 2 point crutch gait: Please note the difference between 2 point gait and 2 point crutch gait.

The crutches and the non-weight bearing, affected limb (due to fracture, amputation, joint replacement etc), are one point and the uninvolved leg is the other point. The crutches and affected limb are advanced as one unit, and the uninvolved weight-bearing limb is brought forward to the crutches as the second unit . this gait pattern is less stable as only two points are in contact with floor and good balance is needed to walk with 2 points crutch gait.

• 2 point gait: the right foot and left crutch are advanced simultaneously, followed by the left foot and right crutch. There are two points in contact with the floor at any one time!
• 3 point: this gait pattern is used when one side lower extremity (LE) is unable to fully bear weight (due to fracture, amputation, joint replacement etc). It involves three points in contact with the floor, the crutches serve as one point, the involved leg as the second point, and the uninvolved leg as the third point. Both crutches move forward, the affected limb then steps up to the crutches followed by the weight-bearing limb step which steps through, and beyond, the crutches. There are always three points of contact with the floor at any given time.
• 4 point: this gait pattern is used when there's lack of coordination, poor balance and muscle weakness in both LE, as it provides slow and stable gait pattern with three points support on it, point one is the crutch on the involved side, point two is the uninvolved leg, point three is the involved leg, and point four is the crutch on the uninvolved side . The crutches and limbs are advanced separately, with three of the four points on the ground and bearing weight any given time.
• Gait to: the fractured limb is advanced, and then the intact limb brought to the same position. When weight-bearing status is restricted to partial, toe-touch, or as tolerated, crutches or a walker are necessary and help the patient step to the fractured limb by pushing down with the upper extremities, thus transferring weight from the fractured limb to the assistive device.
• Gait through: the intact leg is advanced,and then the fractured leg is advanced past it. With restricted weight-bearing, crutches are used instead of the injured limb, and the patient steps past the crutches with the weight-bearing lower extremity; the gait assumes a two-point or three-point pattern.

Indications

The use of crutches may be indicated if a patient:

• Has lost the use of a limb (it is either injured or amputated).
• Is having problems with Balance and impaired strength.

See also

• Canes
• Walkers