John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
There are several basic types of crutches: axillary (underarm), forearm (Lofstrand), platform, strutter, and leg support. All should be custom fitted properly to help reduce movement problems. Crutches are made in all sizes, for adults and children.
Axillary crutch: This is the most common type. Wooden or aluminum models can be adjusted easily to your overall height and hand height. In the stationary position, the top of the crutch should extend from a point the width of
two to three fingers below the armpit (axilla) to a point on the floor 15
cm-20 cm (6 in-8 in) outside your foot. Your hand should rest at a level that allows you to flex your elbow about 30°. If you are unable to stand, simply subtract 16 inches from your height to determine the crutch length you need.
Forearm crutch (also known as the Lofstrand crutch, or elbow crutch): This crutch should allow you to flex your elbow 15°-30°. The increased flexion allows your arm to bear greater weight. The crutch should contact the floor 5
cm-10 cm (2 in-4 in) outside and 15 cm (6 in) in front of your foot. The cuff on the crutch should sit 2.5
cm-4 cm (1 in-1.5 in) below the back of the elbow. This type of crutch is common in Europe, however in the U.S. generally only people with lifelong disabilities such as polio use this type of crutch.
Platform crutch: Also known as a triceps crutch, this crutch should contact roughly 5 cm (2 in) below the skinfold of the armpit. The lower cuff should lie 1
cm-4 cm (0.5 in-1.5 in) below the back of the elbow to avoid bony contact on the arm yet provide stability.
Strutter crutch: This crutch is a type of underarm crutch that has larger crutch tips that remain flat on the floor. This allows for improved weight distribution and more even walking gait.
Leg support crutches: These are like a knee scooter where the affected leg is strapped into a support frame on wheels. Leg support crutches are particularly useful for below the knee injuries or postoperatively after below-the-knee surgery that affect one leg only.