Name of the Procedure:

Common Name: Wooden Underarm Crutch
Technical Term: HCPCS E0113 - Crutch underarm, wood, adjustable or fixed, each, with pad, tip, and handgrip

Summary

A wooden underarm crutch is a mobility aid that helps individuals who need support to walk due to lower extremity injuries, surgeries, or disabilities. These crutches are adjustable or fixed in height and come equipped with pads, tips, and handgrips for comfort and stability.

Purpose

Medical Conditions Addressed:

• Lower limb injuries, fractures, or surgeries
• Disabilities affecting lower extremity function
• Situations requiring weight offloading from a leg

Goals/Expected Outcomes:

• To provide balance and support while walking
• To facilitate movement without placing weight on the injured leg
• To enhance mobility and independence

Indications

Symptoms/Conditions Warranting the Procedure:

• Severe leg pain
• Inability to bear weight on one leg
• Post-operative care requiring limited leg movement

Patient Criteria:

• Sufficient upper body strength
• Adequate arm coordination
• Requirement verified by a healthcare provider

Preparation

Pre-Procedure Instructions:

• Ensure proper measurement for correct crutch height
• Receive training on proper crutch usage
• Wear appropriate footwear

Diagnostic Tests or Assessments:

• Physical assessment by a healthcare provider
• Possible imaging tests to evaluate the injury

Procedure Description

Step-by-Step Explanation:

1. Measurement: Correctly adjust the crutch height so that the top pad is 1.5-2 inches below the armpit when standing upright.
2. Handgrip Adjustment: Set the handgrip at wrist level when arms are hanging naturally.
3. Training: Learn the tripod stance, non-weight bearing methods, and the swing-through gait or other suitable techniques.
4. Usage: Practice walking, standing, and using stairs with guidance.

Tools/Equipment:

• Wooden underarm crutches
• Pads, tips, and handgrips included

Anesthesia/Sedation: Not applicable.

Duration

Initial fitting and training typically take about 30 minutes to 1 hour.

Setting

Fitting and training can be performed in a hospital, outpatient clinic, or rehabilitation center.

Personnel

• Physical therapists
• Occupational therapists
• Orthopedic surgeons or nurses (for initial assessment and guidance)

Risks and Complications

Common Risks:

• Underarm discomfort or chafing
• Hand and wrist pain
• Balance issues

Rare Complications:

• Secondary injuries from falls
• Nerve damage due to improper use
• Skin abrasions or ulcers

Management of Complications:

• Use of additional padding
• Adjustments to crutch fit and usage techniques
• Regular follow-up with a healthcare provider

Benefits

Expected Benefits:

• Increased mobility
• Independence in movement
• Reduced load on injured leg, aiding recovery

Timeframe for Realization: Immediate upon proper training and use.

Recovery

Post-Procedure Care:

• Regularly check and adjust the crutch for wear and fit
• Maintain good posture and correct walking technique

Recovery Time: Varies depending on the underlying condition but typically aligns with the healing period of the leg injury.

Restrictions/Follow-Up: Follow healthcare provider instructions on weight-bearing restrictions and schedule follow-up appointments as needed.

Alternatives

Other Treatment Options:

• Wheelchairs
• Walkers
• Forearm (Lofstrand) crutches

Pros/Cons of Alternatives:

• Wheelchairs: Offer sitting mobility but less upper body workout.
• Walkers: More stable but slower movement.
• Forearm Crutches: Provide better arm support but require more upper body strength.

Patient Experience

During Procedure:

• Expect to focus on balance and coordination training.
• Initial discomfort or soreness in armpits and hands.

After Procedure:

• Adaptation to crutch use can take a few days.
• Mild discomfort in supported areas may be managed with padding and proper technique.
• Continuous improvement in mobility as proficiency with crutches increases.