Musculoskeletal System: Crutches
Monday, December 29, 2025
Musculoskeletal System: Crutches
NCLEX Memory Hints © BrainyNurses.com
Crutches are frequently dispensed in the outpatient setting and education is important for patient safety and to prevent complications.
Use of Crutches
If a patient will need to climb stairs, education should include going up the stairs and going down. To go up, good leg first, bad leg and crutches follow. To go down, bad leg and crutches first, good leg follows.
The height of the crutches should measure 2-3 finger widths below the anterior axillary fold to avoid brachial plexus injury and causing weakness of the forearm.
The handgrip should be placed to allow the angle of elbow flexion to be not less than 30 degrees. If nerve injury occurs, the hand will be numb because the handgrip is improperly placed.
Patients should place the crutches 6-10 inches in front and to the side of the patient’s toes, depending on body size, to provide a wide base of support.
To get out of the chair, crutches are held on the bad side, grasp the arm of the chair with the good side.
Gait Patterns with Crutches
4-Point Gait
• Slow gait pattern and used when able to bear some weight.
• Crutches and legs move separately.
• One crutch is advanced followed by the opposite leg.
• Then the other crutch, followed by the opposite leg.
2-Point Gait
• Like a walking pattern and faster.
• Crutch and the opposite extremity move together.
• Then the other crutch and extremity together.
3-Point Gait
• No weight bearing on one extremity.
• The crutches and affected extremity move forward followed by the unaffected leg.
Swing-to Gait
• Limited use of both lower extremities.
• Both legs are swung forward to meet the crutches.
Swing-through Gait
• Like the swing-to but the body moves past the crutches.
• Not as safe as the swing-to gait.
Memory Hints for Crutches
• Good leg up, bad leg and crutches down for stair climbing.
• Crutch too high, forearm weak.
• Elbow too straight, hand numb.
• Wide base of support 6-10 inches in front and to the side.
• Crutches on the bad side and grasp the chair arm with the good side to get out of the chair.
• 4-point is 4 movements; 2-point is 2 movements and a walking pattern.
• 3-point is no weight bearing on one extremity.
• Swing-through gait is a safety risk.
Summary
In preparing for the NCLEX exam, knowledge of the use of crutches is needed and these “Memory Hints” simplify the most common points tested. Also, remember the importance of safety in any type of assistive device.
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