The correct way to support the abduction?

  The correct way to use crutches, the significance of the following: 1, maximum support to protect the affected limb; 2, to promote the early recovery of normal gait; 3, to ensure that the upper limb in the manipulation of crutches without additional damage; 4, standardize the rehabilitation process.  Usually when using crutches, often mention the word “frame crutch”, in fact, this statement is wrong, the correct term should be “support crutch”. Before using crutches, first of all, the crutches should be adjusted to the correct height, the specific method is: the crutches will stand on the side of the body, the top of the crutches from the armpit 3-5 cm (to avoid the weight of the crutches on the top of the crutches to avoid injury to the blood vessels and nerves in the armpit), the arm drops naturally, the height of the armrest is located in the transverse wrist line (that is, the junction of the palm and forearm). At this time, the forearm flexor and extensor muscles simultaneously exert force to maintain the neutral position of the wrist joint (to avoid injury to the deltoid cartilage disc by bearing weight on the wrist joint in the dorsal extension position), and then the upper limb muscles work together to support the body to achieve the role of support.  Depending on the form and degree of injury, the use of crutches is mainly divided into the following categories: if the patient has a lower extremity injury on one side, partially limiting weight bearing, the use of a single crutch, together with the healthy and affected limbs, a total of “three points” to support the weight, to complete the walking process. If the patient has a lower extremity injury on one side, completely restrict weight-bearing, using double crutches, with the healthy side of the limb, a total of “three points” to support the weight, the affected limb suspended, to complete the walking process. If the patient has bilateral lower extremity injury, both partially restrict weight-bearing, use double crutches, together with bilateral affected limbs, a total of “four points” to support the weight, to complete the walking process. If the bilateral affected limbs are completely restricted weight-bearing, there is no choice but to resort to a wheelchair.  During the normal walking process, the upper limbs should swing alternately with the lower limbs, in the specific order of “left on right” and “right on left”. Therefore, when walking with a single crutch, the correct direction to hold the crutch should be on the healthy side, the healthy side of the crutch and the affected limb equal amplitude, synchronized movement, and strive to rhythm, stride length close to the healthy side of the level, the center of gravity always follow the limb to the front, so that is the correct gait. The correct use of crutches can ensure that the crutches always follow the movement of the affected limb, and the affected limb and crutches are separated from both sides of the body, which can have the largest stable surface to achieve the best protection effect. On the contrary, if held on the affected side, to achieve synchronization of the affected limb and crutches, the gait is bound to “follow the crutches”, the posture is very awkward, which is not conducive to the establishment of normal posture, and more importantly, the affected limb and crutches are on the same side, the distance is very close, and the stable surface during action is only less than half of the correct way, so the protection effect is naturally greatly reduced. Of course, the patient unfortunately happens to be damaged at the same time the upper extremity of the healthy side, at this time in an acceptable way to try to protect it can be.  When the patient’s lower limb injury, completely limit the weight-bearing, the use of double crutches “to support the weight, the affected limb suspended, to complete the walking process. At this time, the crutches should be equal to the affected limb, synchronized movement, although the affected limb suspended but overhead to simulate the normal gait in the flexion and extension movements, in support of weight while maintaining normal gait habits.  When the patient has bilateral lower extremity injuries, both partially restrict weight bearing, the use of double crutches to support the weight to complete the walking process. At this time, the double crutches in the normal order of “left crutch right leg”, “right crutch left leg”, respectively, and both lower limbs equal amplitude synchronous alternate extension, in order to maximize the stability of the area to achieve the protection of the limbs respectively. The gait at this point is fully in line with normal human habits, and although it requires a high level of coordination between the upper and lower limbs, it should not be a problem for the patient to master it through careful teaching.