A physiotherapist fits axillary crutches for a young adult with a fractured tibia who must remain non-weight-bearing. Which description corresponds to correctly fitted axillary crutches?

• A Crutch pad resting tightly in the axilla with elbows fully extended
• B Weight borne through the axillary pad with the hand used only for balance
• C Crutch tip beside the heel, elbow flexed 60 degrees, and pad touching the axillary fold
• D Crutch tip 15 cm ahead of the toes, elbow flexed about 30 degrees, and a two to three finger gap between the axillary pad and the axilla ✓

Explanation

Correct axillary crutch fitting places the crutch tip roughly 12 to 15 cm ahead of the toes, allows 20 to 30 degrees of elbow flexion so the arms can lift the body, and leaves two to three finger breadths of space between the axillary pad and the axilla. Weight should be transmitted through the hands on the handpiece, never through the axilla, because direct axillary pressure compresses the radial nerve in the spiral groove and causes crutch palsy.

Reference: Maheshwari's Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.