Crutches.

Potter, B E; Wallace, W A

doi:10.1136/bmj.301.6759.1037

Cited by 9 publications

(3 citation statements)

References 5 publications

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“…Joyce and Kirby [ 9 ] recommended that there be 5 cm between the anterior axillary fold and the axillary bar. Potter and Wallace [ 10 ] suggested that when standing with the feet together and crutch tips 8 to 10 cm lateral to the feet, there should be 2 to 3 finger breadths of space between the patient’s axilla and the axillary bar. To reduce the risk of injury, patients should be instructed to bear weight through the hands with their elbows extended [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Brachial Artery Aneurysms with Distal Embolisms in a Patient with Prolonged Crutch Compression

Şimşek

Güçlü

Hüseyın

et al. 2021

Vasc Specialist Int

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Chronic axillary crutch use may lead to axillary or brachial artery aneurysms and associated axillobrachial thromboembolic complications. Most of these aneurysms remain asymptomatic and undiagnosed until a complication occurs. Early diagnosis and appropriate surgical management of the aneurysms is required for a favorable outcome. We report a case of bilateral brachial artery aneurysms with left radial and ulnar artery embolisms in a patient who had been using crutches for 33 years due to a congenital skeletal anomaly.

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Section: Discussionmentioning

confidence: 99%

Bilateral Brachial Artery Aneurysms with Distal Embolisms in a Patient with Prolonged Crutch Compression

Şimşek

Güçlü

Hüseyın

et al. 2021

Vasc Specialist Int

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“…Participants were then fitted with a pair of axillary crutches by a physiatrist trained in crutch fitting (R.M. ), using guidelines published by Potter and Wallace 11 . This method of crutch fitting was chosen as it was feasible to do easily and quickly (ie, did not require making precise measurements with calipers as other methods for crutch fitting outlined in the Introduction) and was comparable to commonly used clinical techniques.…”

Section: Methodsmentioning

confidence: 99%

“…Other authors reported optimal crutch length based on clinical experience. For example, Joyce and Kirby indicated that there should be 5 cm of space between the axillary bar and the anterior axillary fold, 10 and Potter and Wallace suggested there should be two to three fingerbreadths of space between the axilla and the axillary bar 11 …”

Section: Introductionmentioning

confidence: 99%

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Kuntze

Russell

Jivan

et al. 2022

PM&R

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Background: Axillary crutches are commonly used in rehabilitation. Inappropriately fit crutches may result in upper limb pain or injury. Objective: To investigate the effects of axillary crutch length on upper limb kinematics to better understand potential injury mechanisms. It was hypothesized that crutches that were longer or shorter than standard-fit crutches would alter upper limb kinematics. Design: Cross-sectional. Setting: Gait laboratory. Participants: Fifteen healthy males with no prior crutch experience. Interventions: Participants were fit with axillary crutches using standardized methods, as well as with crutches that were 5 cm longer and 5 cm shorter. Participants performed swing-through gait (1.20 AE 0.07 ms À1 ) with all crutch lengths in randomized order. Kinematics were recorded using an optical motion-tracking system and joint angles for the scapula, shoulder, elbow, and wrist were computed. Main Outcome Measures: The effects of crutch length on joint range of motion (ROM) and joint angles at initial crutch contact were analyzed using multivariate analysis (Hotelling's T 2 ; α = .025) and simultaneous confidence intervals (CI). Results: The long-standard crutch fit comparison showed effects across all joints (ROM p = .009; initial contact p < .001). Longer crutches resulted in greater scapular upward rotation (mean difference [95% CI] ROM: 1.0 [À0.2 to 2.2]; initial contact: À2.7 [À4.4, À1.1]) and shoulder abduction (ROM: 0.8 [À0.1 to 1.8]; initial contact: À1.9 [À4.1 to 0.3]). Crutch length also had effects across all joints for the short-standard fit comparison (ROM p = .004; initial contact p = .016). Shorter crutches resulted in greater scapula downward rotation (2.2 [À0.4 to 4.8]) and greater shoulder adduction (2.5 [À0.6 to 5.6]) at initial contact. Shorter crutches also reduced shoulder flexion/extension ROM (À2.5 [À4.4 to À0.6]). Conclusions: Altered crutch length results in scapular and shoulder kinematic deviations that may present risk factors for upper limb injury with crutch-walking. This may underline the importance of appropriate device fitting to reduce injury risk in crutch users.

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Injuries Associated with Crutch Use: A Narrative Review

Manocha

MacGillivray

Eshraghi

et al. 2020

PM&R

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Crutches are commonly prescribed in physiatric settings to help offload the lower extremities. Crutch use, however, results in abnormal and repetitive weight-bearing through the upper extremities that may result in secondary injury. This narrative review investigates injury types and risk factors associated with crutch use in order to guide healthcare providers on injury prevention strategies. Medline, EMBASE, CINAHL, and the Cochrane Library were systematically reviewed for publications between 1950 and 2018 on neurological, musculoskeletal, or vascular complications associated with crutch use. Titles and abstracts (n = 2395) were screened by two authors. Sixty studies were eligible. Articles were reviewed for level of evidence, crutch type, participant characteristics, and injury characteristics. There were 42 axillary crutch studies, 12 forearm crutch studies, and 6 studies that did not specify crutch type. These studies incorporated 622 individuals, and most were case series or case reports (n = 54). Axillary crutch use was most commonly associated with axillobrachial arterial complications due to pressure from the axillary bar (n = 34). Forearm crutch use was most commonly associated with compressive neuropathies due to pressure from the forearm cuff (n = 6). Improper crutch fitting and/or use were identified as contributing factors to injury in 22 cases. Duration of crutch use and medical comorbidities also influenced the types of injuries seen. There are rare but potentially serious complications associated with crutch use. When prescribing crutches, clinicians should ensure they are properly fit, engage in appropriate gait training, be aware of common crutch-related injuries, and consider potential patient-specific injury risk factors in order to minimize injury risk.

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Crutches.

Cited by 9 publications

References 5 publications

Bilateral Brachial Artery Aneurysms with Distal Embolisms in a Patient with Prolonged Crutch Compression

Bilateral Brachial Artery Aneurysms with Distal Embolisms in a Patient with Prolonged Crutch Compression

The effect of axillary crutch length on upper limb kinematics during swing‐through gait

Injuries Associated with Crutch Use: A Narrative Review

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