D.3 Peripheral nerve injuries related to walking aid use: a systematic review

Abstract

Background: Walking aids such as crutches, canes and walkers are used by 2 million Canadians. Repetitive weight-bearing with walking aids may cause upper limb peripheral nerve injury. The objectives of this review were to: 1) identify types of nerve injuries reported with walking aids; 2) report electrodiagnostic findings; 3) identify typical treatment strategies; and 4) determine expected recovery time for such injuries. Methods: MEDLINE, EMBASE, CINAHL and Cochrane Library were searched for primary data in English published between 1950-2022. Abstracts were reviewed independently by 2 authors. Full-text reviews were independently conducted by 2 authors. Results: The search identified 3746 abstracts, 43 of which underwent full-text review. 31 studies were included. There were 144 cases of peripheral nerve injury. Crutches caused the most injuries (n=21 studies). The ulnar nerve was most commonly injured (n=27 cases). Improper walking aid fit was identified as a risk factor in 74% of cases. Stopping walking aid use was the most common treatment strategy (n=10 studies). Follow-up reports (n=20) indicated 65% of patients experienced recovery at 6 months. Conclusions: Improper walking aid fit and use were identified as major injury risk factors. A national program to teach patients and clinicians how to use walking aids may reduce injury risk.