The patient has been using crutches for the past 2 weeks. When she comes for her follow-up examination, she complains of tingling and numbness in her hands and upper torso. Possible causes of these symptoms are:
a. the patient's elbows are flexed 15 to 30 degrees when using the crutches.
b. crutch pad is approximately 2 inches below the patient's axilla.
c. patient holds the cane 4 to 6 inches to the side of her foot.
d. handgrip does not allow for elbow flexion.
D
Instruct the patient to report any tingling or numbness in the upper torso, which may mean that the crutches are being used incorrectly, or that they are the wrong size. If the handgrip is too low, radial nerve damage can occur even if overall crutch length is correct, because the extra length between the handgrip and the axillary bar can force the bar up into the axilla as the patient stretches down to reach the handgrip. After correct crutch adjustment, two to three fingers must fit between the top of the crutch and the axilla. Adequate space prevents crutch palsy. Proper fit is when the crutch pad is approximately 2 inches or two to three finger widths under the axilla, with the crutch tips positioned 6 inches (15 cm) lateral to the patient's heel.
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