Modified crutch for the upper extremity amputee with lower extremity involvement.

The Prosthetics/Orthotics and Physical Therapy Departments were faced with the challenge of creating a modified crutch for an upper extremity amputee with lower extremity involvement. A 46-year-old man, with congenital absence of both fibulae and his left arm from above the elbow, underwent a left total hip replacement in March 1979. He then had a left supracondylar osteotomy for valgus deformity in July of the same year. The patient's left lower extremity was supported in a splint, and he was to ambulate nonweight bearing on the left. He had an upper extremity prosthesis but chose not to wear it because of extreme discomfort. After surgery, the patient's goals were to become independent in transfers and in ambulation both on level surfaces and stairs. Therefore, we needed to design a device whereby the patient could achieve these goals. To allow this patient to use crutches, and for ease of fabrication, we made an open-socket mold from the patient's stump out of Orthoplast* in accordance with general prosthetic principles. We bonded the open socket to a strip of Orthoplast by heating the two pieces together with a heat gun and trimmed the strip to the shape desired. We then brushed carbon tetrachloride over the Orthoplast to enhance its adherent qualities and wrapped the socket and the strip around the vertical sides of the crutch (Fig. 1). The patient wore a stockinette over his