Crutches

Crutches are mobile aids that transfer weight from the legs to the upper body. The device itself is a wooden or metal vertical support that helps support the disabled person while walking. Crutches are located from the surface on which they walk to the armpit or arm. They are often used by people with disabilities to support their weight for reasons related to short-term injury or old age.

What are medical crutches?

Crutches have been used since ancient Egypt. In 1917, Emil Schlick patented the first commercial crutch, the design of which consisted of a cane resting on the shoulder. Later, A. R. Lofstrand, Jr. developed the first fixtures with a height-adjustable feature that allows you to adjust the desired length.

Over time, the design has not changed much, so the classic look is still the most commonly used in medical practice.

The crutch is selected in accordance with the needs of the person. It can serve as both partial support and absolute support for the entire body.

They are mainly used after surgery or in case of a fracture of the limbs to reduce the load on the legs. There are also special crutches (completely take on the weight of the body), which is necessary for people who cannot move normally on their own.

A typical hardwood arm crutch is 20 inches deep—two long bars joined together, about 4 feet or more in length, that taper at the bottom and radiate upward, like a “Y” for example, to a maximum width of about 5 inches at the top. At the top is a padded horizontal piece 6″ to 8″ wide, suitable for underarm body support. In the middle of the device between the tapering shafts is a jumper used as a handle. Holes, bolts and wing nuts on the sides of the lower shaft, as well as two tapered upper shafts, allow a person to adjust the length and position of the handle.

The conventional aluminum armrest has a similar design with buttons to allow for easy adjustment. The handle is usually metal, has a single shaft with a protruding handle and a cuff that wraps around the hand. At the bottom of the crutches there is a special rubber tip.

Types of crutches

These supports are of several types:

• axillary;
• forearm;
• platform;
• with leg support.

Axillary crutches place the handle perpendicular to the chest under the armpit. They are usually used to support patients who have a temporary restriction on movement. These canes sometimes require a towel or some sort of soft covering to prevent or reduce damage to the armpit.

A complication known as crutch palsy can occur due to pressure on the nerves in the armpit or armpit. In particular, the brachial plexus in the armpit is often damaged by the pressure of the handle. In these cases, the radial nerve is the most common nerve in the forearm, and the ulnar nerve is affected to the same extent nearby.

An uncommon type of underarm cane is the spring-loaded crutch. The underarm padding is a curved design that is open at the front with hand grips to provide maximum comfort and reduce the incidence of overuse injuries.

This view also contains a spring mechanism at the bottom. Its design idea is to allow the user to move further, resulting in faster movement from place to place, although studies have shown that the difference in speed is very small when compared to standard axillary crutches. They are most commonly used by young people.

A typical forearm crutch has a cuff on top that wraps around it. It is used by inserting the hand into the given fixture and holding the grip.

The cuff, usually made of plastic or metal, may be semi-circular or full circle with a V-type opening in the front to allow the forearm to be pushed out in the event of a fall. Forearm canes are the dominant type in Europe for both short and long term use. Outside of them, patients with severe impairments are likely to be used, as axillary is the more common option for short-term use.

Platform crutches are less common and are used by those with poor hand grip due to arthritis, cerebral palsy, or other conditions. The arm rests on a horizontal platform and is fixed in place, and if properly designed, can be angled appropriately depending on the user’s disability.

Leg support is a special type of crutches. This non-traditional support is useful for users with an injury or disability affecting only one leg. They function by wrapping the affected leg in a support frame that simultaneously holds the lower portion off the ground, transferring the load from the ground to the wearer’s knee or hip. This style has the advantage that the patient does not use their hands while walking.

They have several advantages:

• free hands;
• reduce the load on the hip;
• the second leg is free;
• the ability to partially use a sore leg.

Thus, atrophy of the upper thigh is reduced, because the affected leg remains in work. Unlike other designs, this fixture is unsuitable for pelvic or hip injuries, and in some cases, knee injuries. Because of this, walking sticks can be used in addition to this device. However, they are held in the hand and have limited bearing capacity.

How to use crutches correctly?

When using one crutch, you will notice that it is placed on the side of the unprotected leg. Those who can accommodate partial weight-bearing on both feet usually use a four-point gait. Those who can bear partial weight bearing on both legs but need less support than the four-point gait usually use the two-point gait. The sequence is the right crutch with the left foot, and then the left crutch with the right foot. The three-point variation of walking is commonly used by those who cannot put all their weight on one foot. Both crutches promote body weight on the healthy leg. This leg is then moved under weight on canes.

A person with an injury typically performs a “turning” gait: while raising the affected leg, the user places both crutches in front of them and then swings their uninjured leg to meet them.

The knee scooter and wheelchair are alternatives for patients who are unable to use or dislike familiar support. However, these wheeled devices introduce an additional limitation as they cannot operate on stairs.

How to choose crutches?

Crutches are made in different sizes, suitable for people with their individual height. Most of them are made of wood or tubular aluminum. The standard type is a high support that runs under the armpit with double posts and a small horizontal handle between them. The bottom part can be adjusted to allow expansion. There should always be a rubber suction tip to prevent slipping.

Often used is the Lofstrand crutch, which consists of a single aluminum tube surmounted by a metal cuff that fits around the forearm. Thus, the user maintains his weight. He can release the handle and grab the railing to climb the stairs without dropping the fixture. The Lofstrand variant is a Canadian elbow extensor crutch that goes further down the arm.

When walking with crutches, the forces of movement are transferred from the feet to the hands. The muscles of the arms, shoulders, back, and chest work together to manipulate the crutches. The type of crutches used depends largely on the nature of the disability. In some cases, the legs can partially function and carry part of the body weight, so the help from crutches is many times less. In other cases, leg braces are required for reinforcement.

The user independently learns one of several standard methods or approaches, depending on the underlying condition. In the end, the patient must learn two main rules: a fast mode of movement for speed in the open air and a slow one for crowded places where the main need is to maintain balance. Different gaits also help relieve fatigue because one set of muscles can rest while another is actively working.

When describing walking, each foot and cane is called a point. In such a case, a two-point gait, for example, means that two of the four points are in contact with the ground during one step. The three-point gait can be used when one leg is stronger than the other – two crutches and the weaker leg are simultaneously fixed on the ground, and the next step is taken with a strong limb. Also in medicine there is a so-called tripod (swinging) gait.

This material will be useful when choosing crutches and their direct operation.