Crutch

For other uses, see Crutch (disambiguation).

Using underarm crutches A typical forearm crutch

Crutches are mobility aids used to counter a mobility impairment or an injury that limits walking ability.

Types

There are several different types of crutches:

Forearm 

Forearm crutches are crutches with a cuff at the top to go around the forearm, and are also known as the Lofstrand crutch. They have been the type most commonly used in Europe; in the United States and Canada, they have been almost exclusively used by people with permanent or lifelong 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 

In the United States underarm crutches 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 underarm 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 disability.

Leg Support 

These non-traditional crutches are useful for users with an injury or disability affecting one lower leg only. They function by strapping the affected leg into a support frame that simultaneously holds the lower leg clear of the ground while transferring the load from the ground to the user's knee or thigh. This style of crutch has the advantage of not using the hands or arms while walking. A claimed benefit is that upper thigh atrophy is also reduced because the affected leg remains in use. Unlike other crutch designs these designs are unusable for pelvic, hip or thigh injuries and in some cases for knee injuries also.

Walking sticks (canes)

For more details on this topic, see Cane (walking stick).

Walking sticks or canes serve an identical purpose to crutches, but are held only in the hand and have a limited load bearing capability because of this.

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 non-weight bearing injury generally performs a "swing-to" gait: lifting the affected leg, the user 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

Innovative Crutch

The knee scooter and the wheelchair are possible alternatives for patients who cannot use or do not like crutches. 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
5. carbon fiber reinforced polymer

Patents and inventions

Emile Schlick, a French mechanical engineer, patented a walking stick that provided an oblique support at the upper end for resting the forearm.^{[citation needed]} This invention was first patented in Nancy (France) on May 7, 1915.^{[citation needed]} Philipp Cederstom patented a similar-looking cane crutch. 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).

Different variations of walking and mobility devices have appeared on the market, notably one called the Strongarm Forearm Crutch,^[5] which is a combination between a traditional walking cane and forearm crutch.^[6] The inventor of the Strongarm Forearm Crutch, Michael E. Adams of patented this device ^[7]

See also

• Assistive technology

References

1. ^ Walk Easy > Interact > Crutch Gait. Retrieved on March 22, 2007.
2. ^ Glanze, W.D., Anderson, K.N., & Anderson, L.E, ed (1990). Mosby's Medical, Nursing, and Allied Health Dictionary (3rd ed.). St. Louis, Missouri: The C.V. Mosby Co.. ISBN 0-8016-3227-7.  p.324
3. ^ ^{a b} Warwick, R., & Williams, P.L, ed (1973). Gray’s Anatomy (35th ed.). London: Longman.  p.1046
4. ^ Kluttz, Sherri L. 1998. Collapsible sectional lofstrand-type crutch. U.S. Patent No. 5,771,910, filed July 24, 1997 and issued June 30, 1998.
5. ^ Strongarm Mobility web site
6. ^ GearAbility article on 1/11/2007
7. ^ US Patent 7,610,926 Mobility Device

External links

• Video of patient using the oneCrutch knee support crutch