crutch

A patient using underarm crutches

A typical forearm crutch

Crutches are medical devices used when a patient is injured usually anywhere below the waist. They usually consist of supports to provide the patient with extra stability to enable normal movement.

Types

There are several different types of medical crutches:

Forearm 

Forearm crutches are the type most commonly used in Europe, but in the United States and Canada, are almost exclusively used by people with permanent disabilities. However, American orthopaedic surgeons are now beginning to prescribe forearm crutches for patients with shorter-term needs. Forearm crutches are used by slipping the arm into a cuff and holding the grip. The cuff, typically made of plastic or metal, can be a half-circle or a full circle with a V-type opening in the front allowing the forearm to slip out in case of a fall.

Underarm 

These are the most common type in the United States, and are used most often by people with temporary disability or injury. These are used by placing the pads against the ribcage beneath the armpits and holding the grip, which is below and parallel to the pad. These are sometimes known as axillary crutches.

Strutters 

These are a variation on under-arm crutches, incorporating large soles which remain flat on the floor or ground while the user walks. They allow for an improved walking gait, and distribute body weight to reduce the risk of nerve damage caused by underarm crutches.

Platform 

These are less common and used by those with poor hand grip due to arthritis, cerebral palsy, or other condition. The arm rests on a horizontal platform and is strapped in place. The hand rests on a grip which, if properly designed, can be angled appropriately depending on the user's physical handicap.

Knee Support 

These crutches are useful for patients whose injury or disability is below the knee. They allow the knee of the injured leg to be placed on a support, so the injured leg now points backward behind the patient. This style of crutch affords the patient the ability to have one or both hands free to carry objects. Upper thigh atrophy is also reduced because half the patients weight is now supported by each thigh rather than one thigh and the arms.

Walking sticks ('canes')

Walking sticks are simple crutches for those who can get around easily on their own; sometimes called "canes." Hemiplegic and balance-impaired persons use the stick to give a better sense of vertical position while lessening vertigo. Without such a stick, one may perhaps not move in a straight line. The stick is held in the stronger hand.

Information on use

Several different gait patterns are possible, and the user chooses which one to use depending on the reason the crutches are needed. For example, a person with a leg injury generally performs a "swing-to" gait: lifting the injured leg, the patient places both crutches in front of himself, and then swings his uninjured leg to meet the crutches. Other gaits are used when both legs are equally affected by some disability, or when the injured leg is partially weight bearing.^[1]

With underarm crutches, sometimes a towel or some kind of soft cover is needed to prevent or reduce under arm injury. A condition known as crutch paralysis, or crutch palsy can arise from pressure on nerves in the armpit, or axilla.^{[2] [3]} Specifically, "the brachial plexus in the axilla is often damaged from the pressure of a crutch...In these cases the radial is the nerve most frequently implicated; the ulnar nerve suffers next in frequency".^[3]

Alternative Devices

The knee scooter and the wheelchair are possible alternatives for patients who cannot use or do not like crutches. The scooter, in particular, has gained favor because it requires less of the patient's energy to propel. These wheeled devices introduce an additional limitation, however, since they cannot negotiate stairs.

Materials

1. Wood
2. Metal alloys (most often Steel, Aluminium alloys, Titanium alloys)
3. Carbon or glass fiber reinforced composites
4. thermoplastic

Patents

Emile Schlick, a French mechanical engineer, patented a walking stick (US patent number 1244249, filed Oct. 23, 1917) that provided an oblique support at the upper end for resting the forearm. This invention was first patented in France on May 7, 1915. Philipp Cederstom patented a similar-looking cane crutch (US Patent 2192766). Finally, the invention of A. R. Lofstrand, Jr., who filed a patent in 1945, consists of an adjustable-length crutch. In the US, forearm crutches are also sometimes referred to as Lofstrands,^[4] Canadian crutches (since they are commonly used in Canada), elbow crutches or even Walk Easies (Walk Easy is a brand name).

References

External links

• Video of patient using the oneCrutch knee support crutch