Pharm
Crutches
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Crutches
, Axillary Crutches, Forearm Crutches, Canadian Crutches, Lofstrand Crutches
See Also
Mobility Device
Assistive Technology
Canes
Walkers
Indication
Gait
disturbance (full weight bearing)
Advantages
Significant weight bearing support (80% for one crutch and 100% for two Crutches)
Disadvantages
High energy expenditure and upper body strength requirement
Unsuitable option for frail elderly
Types
Axillary Crutches
For temporary use (acute injuries)
Adjustable aluminum or wooden Crutches
Requires significant upper body strength
May be difficult to use and cumbersome
Risk of nerve or artery compression in axilla if incorrectly used
Forearm Crutches (Canadian crutch, Lofstrand crutch)
For active patients with severe leg weakness
Offers easier mobility than with Axillary Crutches
Brace fixes crutch to
Forearm
and hands grasp handles
Allows use of hands without dropping Crutches
Less cumbersome on stairs than axillary crutch
Technique
Two point
Advance left crutch and right leg together, then
Advance right crutch and left leg together
Four point (most stable)
Crutches and legs move independently
Advance left crutch
Advance right leg
Advance right crutch
Advance left leg
Fitting
Axillary Crutches
Elbow
s bent to 30 degrees flexion while holding crutch handles
Crutch base sits 6 inches anterior and 2 inches lateral to foot
Allow adequate space between top of crutch and axilla
Crutch top should have a space of 4-5 cm (~2 inches) below axilla
Axilla should not rest on top of crutch
Forearm Crutches (Canadian crutch, Lofstrand crutch)
Plant crutch end in front of foot by 6 inches
Keep elbow slightly flexed to 15 to 30 degrees
Place cuff at proximal
Forearm
just distal to elbow (2.5 to 4 cm below the olecranon)
References
Bradley (2011) Am Fam Physician 84(4): 405-11 [PubMed]
Van Hook (2003) Am Fam Physician 67(8):1717-24 [PubMed]
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