II. Indication
- Gait disturbance (full weight bearing)
III. Advantages
- Significant weight bearing support (80% for one crutch and 100% for two Crutches)
IV. Disadvantages
- High energy expenditure and upper body strength requirement
- Unsuitable option for frail elderly
V. 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
VI. 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
VII. Fitting
- Axillary Crutches
- Elbows 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)
