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Crutches are medical devices designed to aid in ambulation, by transferring body weight from the legs to the torso and arms. They are mainly used to assist individuals with lower extremity injuries and/or neurological impairment. This activity describes the types of crutches, their indications, and contraindications and highlights the role of the interprofessional team in proper evaluation and training of patients needing ambulatory devices. Objectives: Describe the indications for crutches. Review the contraindications of crutches. Summarize the types of crutches available. Explain the importance of improving care coordination among interprofessional team members to improve outcomes for patients needing an ambulatory device. Access free multiple choice questions on this topic.

Crutches are medical devices designed to aid in ambulation, by transferring body weight from the legs to the torso and arms.[1]  They are mainly used to assist individuals with lower extremity injuries and/or neurological impairment.  Most crutches classify into the following three categories: axilla, forearm, and platform.

The user’s strength and coordination should undergo evaluation before issuing them a set of crutches.  The use of the wrong crutches can lead to injury.  Most injuries are a direct result of falling. Crutch palsy is observable in axilla crutch users who rest their weight on the shoulder rest.  The pressure on the brachial plexus can result in palsy to the radial and ulnar nerves.  Extra padding on the shoulder rest can aid in preventing crutch palsy. Education should be provided to patients to discourage supporting body weight on the shoulder rest. With treatment, this can be a repairable injury.[3][4][5]

Advances in crutch technology are ongoing.  The crutches are separated into their component parts and examined separately.  The shoulder rest of the axilla crutches can lead to crutch palsy.  Manufacturers have added softer and more pliable padding to the shoulder rest.  However, the addition of extra padding can reduce the space between the axilla and shoulder rest leading to what it was intended to prevent.  U- shaped or concave shoulder rest helps to solve the reduced space issue.[6] Hand grips are part of each class of crutches.  They serve as a significant connection between the crutch and the user.  Hand grips have always been adjustable in the up, down, forward and back positioning depending on the crutch.  Newer crutches have added more grip positions, which reduces the strain on the user’s wrist and aid in improved stability.  New advances in design include more comfortable grips.[7] The ailments of the crutch user are variable.  The user’s musculoskeletal and/or neurological impairments limit the amount of weight that they can carry.  Thus, the crutch should add the least amount of weight.  The old wooden crutches are no longer in use.  Lighter weight composites such as aluminum, titanium, and carbon fiber are now the norm in designs.[8] Crutches are mainly intended to aid the user with their mobility.  Engineers are looking at designs that will help move the user forward.  User assistant features such as spring-loaded main tubes and struts are stated to increase the user’s momentum.[9] Unfortunately, not all studies have supported this particular engineering feature. Rubber tips connect the user to the ground.  Larger rubber tips are used to provide added stability.  Newer composites can give a more streamlined design. They can offer more grip with less surface area.  Pivoting tips may allow for more maneuverability.[10][11] In addition to the prescribing physician, the therapist, nurse, and pharmacist can also evaluate the patient for the need for crutches. In fact, most pharmacies sell crutches and other ambulatory devices. an interprofessional team approach among all the entities just mentioned can assist the patient in crutch selection, fitting, and use to achieve optimal patient outcomes.

In addition to the prescribing physician, the therapist, nurse, and pharmacist can also evaluate the patient for the need for crutches. In fact, most pharmacies sell crutches and other ambulatory devices. an interprofessional team approach among all the entities just mentioned can assist the patient in crutch selection, fitting, and use to achieve optimal patient outcomes. Before the potential user tries to use the most technological advance crutch, they must undergo proper fitting.  The user must also remember that not all the technical advances have scientific proof to back up their claims.