The readme is not clear at all how to use this thing, can someone tell me please? I would disable it but for some reason my game will not load without this enabled. I don't really mind, but I kinda need to know how to use it.

Thanks

I think the question is not how to use Enhanced Hotkeys, but how to use the vanilla hotkey system? Try to press and hold a number on your keyboard and the vanilla or Enhanced Hotkeys hotkey layout will appear, then you just need to assign an item or spell to the button you are holding by left-clicking on the item/spell. Of course Enhanced Hotkeys adds a lot more functionality to this system, but you can set up everything with the INI. Hope that helps.

I prefer discussion about Enhanced Hotkeys in its http://www.gamesas.com/index.php?/topic/1167647-relz-enhanced-hotkeys/, so please post further questions there. The only possible cause of CTD related to EH is if you try to uninstall it, but only do so partially, with EH's quickkeys_menu.xml file remaining while having removed its other xml files. If you do this, it will cause CTD when you try to load a savegame. This is fixed by correctly remove the quickkeys_menu.xml installed by EH too.