title: Reduction in ulnar pressure distribution when walking with forearm crutches with a novel cuff design: Cross-sectional intervention study on the biomechanical efficacy of an ulnar recess.
abstract: Walking with crutches is an effective way of reducing the load on the lower extremity and is often indicated after injury or surgery. However, walking with forearm crutches with conventional cuffs can trigger symptoms including tenosynovitis in the biceps tendon, ulnar neuropraxia at the wrist, pain, or skin hematoma. The purpose of this study was to test the hypothesis that a crutch cuff design with an ulnar recess reduces ulnar pressure during walking with forearm crutches. The pressure distribution between the forearm and crutch cuff was measured in 15 healthy participants for crutch walking with conventional and novel cuffs, respectively. Relative peak pressure in the proximal medial region compared to the overall peak pressure was reduced by 8.6% when walking with crutches with the novel cuff design compared to conventional cuffs (p < 0.001). Relative peak pressure in the distal intermediate and lateral regions were increased by 3.3% and 3.7% for the novel compared with conventional cuffs, respectively (p < 0.001 for both). Hence, the novel crutch cuffs shifted regions of high pressure away from the proximal ulnar region towards more distal regions that are covered by more soft tissue.
authors.affiliation: a Clinic for Orthopaedics and Traumatology , University Hospital Basel , Basel , Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Molteni
authors.affiliation: b Department of Rheumatology , University Hospital Basel , Basel , Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hügle
authors.affiliation: c Department of Computer Science , University of Freiburg , Freiburg im Breisgau , Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Hügle
authors.affiliation: d Clinic for Orthopaedics and Traumatology , University Hospital Basel , Basel , Switzerland.|e Department of Biomedical Engineering , University of Basel , Allschwil , Switzerland.
authors.forename: Corina
authors.initials: C
authors.lastname: Nüesch
authors.affiliation: f Clinic for Orthopaedics and Traumatology , University Hospital Basel , Basel , Switzerland.|g Department of Biomedical Engineering , University of Basel , Allschwil , Switzerland.
authors.forename: Annegret
authors.identifier: 0000-0002-6472-1689
authors.initials: A
authors.lastname: Mündermann
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena / Q000502:physiology*; D003430:Cross-Sectional Studies; D003446:Crutches / Q000009:adverse effects / Q000592:standards; D004867:Equipment Design / Q000592:standards; D005260:Female; D005542:Forearm; D005684:Gait / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014457:Ulna / Q000502:physiology*; D016474:Weight-Bearing
keywords: center of pressure; crutch walking; pressure distribution; ulnar recess