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Crutches and children - proper fit and safety tips

After surgery or an injury, your child may need crutches to walk. Your child needs crutches for support so that no weight or only partial weight is put on your child's leg. Using crutches isn't easy and takes practice. Make sure that your child's crutches fit right and learn some safety tips.

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Fitting Crutches

Ask your child's health care provider to fit the crutches to your child. Proper fit makes using crutches easier and keeps your child from getting hurt when using them. Even if your child is fitted for their crutches:

• Keep the rubber caps on the underarm pads, handgrips, and feet.
• Adjust the crutches to the right length. With the crutches upright and your child standing, make sure you can put 2 fingers or an inch between your child's underarm and the top of the crutches. They should not be leaning on the crutches against the underarm pads. Crutch pads against the armpit can give your child a rash and put pressure on nerves and blood vessels in the arm. Too much pressure can damage nerves and blood vessels.
• Adjust the height of the handgrips. They should be where your child's wrists are when their arms are hanging by their side or hip. The elbows should be gently bent when standing up and holding the handgrips without the crutches touching the armpits.
• Make sure your child's elbows are slightly bent when starting to use the crutch, then extended when taking a step.

Safety Tips

Teach your child to:

• Always keep crutches nearby in easy reach.
• Wear shoes that do not slip off, avoiding, for example, slippers or flip flops.
• Move slowly. The crutch may get caught on something or slip when you try to move too quickly.
• Watch for slippery walking surface. Leaves, ice, and snow are all slippery. Slipping is not generally a problem on wet roads or sidewalks if the crutches have rubber tips. But wet crutch tips on indoor floors can be very slippery.
• Never hang on the crutches. This puts pressure on the arm nerve and can cause damage.
• Carry a backpack with necessities. This way things are easy to reach and out of the way.

Things parents can do:

• Put away things in your home that could cause your child to trip. This includes electrical cords, toys, throw rugs, and clothes on the floor.
• Talk to your child's school to give your child extra time to go between classes and to avoid crowds in the hallway. See if your child can ask for permission to use the elevators and avoid stairs.
• Check the crutch feet for tread. Make sure they are not slippery.
• Check the screws on the crutches every few days. They get loose easily.

When to Call the Doctor

Contact the provider if your child does not seem safe on crutches even after practicing with you. The provider can refer you to a physical therapist who can teach your child how to use crutches.

If your child complains of numbing, tingling, or loss of feeling in their arm or hand, call the provider.

References

American Academy of Orthopaedic Surgeons website. How to use crutches, canes, and walkers. orthoinfo.aaos.org/en/recovery/how-to-use-crutches-canes-and-walkers. Updated December 2020. Accessed January 18, 2023.

Edelstein J. Canes, crutches, and walkers. In: Webster JB, Murphy DP, eds. Atlas of Orthoses and Assistive Devices. 5th ed. Philadelphia, PA: Elsevier; 2019:chap 36.

Osorio M, Tsao E, Apkon SD. Ambulation assistance. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 733.

Review Date: 12/12/2022  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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