Name of the Procedure:

Crutch, Underarm, Articulating, Spring-Assisted (HCPCS E0117)

Common name(s): Spring-Assisted Crutch, Dynamic Underarm Crutch

Summary

The Spring-Assisted Underarm Crutch (E0117) is designed to provide mobility support for individuals with lower extremity injuries or disabilities. It features a spring mechanism that helps in reducing the impact forces on the user's body and improving comfort during walking.

Purpose

• Medical Conditions Addressed: Lower extremity injuries, post-surgical recovery, arthritis, mobility impairments.
• Goals/Outcomes: Enhance mobility, reduce pressure on underarms and wrists, increase user comfort and stability, and promote a quicker and more comfortable rehabilitation process.

Indications

• Individuals with temporary or permanent lower limb disabilities.
• Patients recovering from leg, knee, or foot surgeries.
• Conditions such as bone fractures, arthritis, or severe sprains.

Preparation

• Pre-procedure Instructions: No specific fasting or medication adjustments required.
• Diagnostic Tests: Assessments of the patient's height, weight, and physical condition to ensure correct crutch fitting.

Procedure Description

1. Fitting the Crutch: Adjust the height of the crutch to ensure that it fits properly, with the top of the crutch settled just below the armpit (about 1-2 inches) and the handgrip aligned with the wrist, allowing a slight bend in the elbow.
2. Training for Use: Healthcare professionals will train the patient on the correct method to use the crutches to prevent injuries and maximize efficiency.
3. Walking Pattern: Instruction on the tripod alternating gait (moving one crutch and the opposite leg forward simultaneously, followed by the other crutch and the opposite leg).

Tools and Equipment: Spring-assisted underarm crutches.

Anesthesia or Sedation: Not applicable.

Duration

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

Setting

Performed in a hospital, outpatient clinic, or rehabilitation center.

Personnel

• Physical Therapists
• Occupational Therapists
• Rehabilitation Specialists

Risks and Complications

• Common Risks: Skin irritation or bruising under the arms, hand or wrist strain.
• Rare Risks: Falls due to improper use, worsening of existing injuries or conditions.

Management: Proper training and gradual acclimatization to crutch use, regular monitoring for signs of discomfort or complications.

Benefits

• Expected Benefits: Immediate improvement in mobility, reduced physical strain compared to standard crutches.
• Realization Timeline: Benefits can often be felt immediately upon proper fitting and use.

Recovery

• Post-procedure Care: Regular checks for fitting adjustments and signs of wear and tear on the crutches.
• Recovery Time: Depends on the underlying medical condition; for injuries, may range from a few weeks to several months.
• Restrictions and Follow-up: Adhere to the advised use of crutches and attend scheduled follow-up appointments to monitor progress.

Alternatives

• Other Options: Standard underarm crutches, forearm crutches, knee walker, wheelchairs.
• Pros and Cons: Standard crutches are less expensive but can be less comfortable and cause more strain. Forearm crutches provide more stability but can be physically demanding. Knee walkers and wheelchairs offer good mobility but are not always suitable for all users or environments.

Patient Experience

• During Procedure: User training sessions might be challenging initially but are essential for safe and effective crutch use.
• After Procedure: Patients can expect some soreness or discomfort as they get used to the crutches; however, the spring mechanism significantly reduces the discomfort compared to standard crutches.
• Pain Management: Ergonomic design and spring assistance aim to reduce pain and improve overall comfort. Regular breaks and gradual adaptation are advised to manage any discomfort.