REIDER PART 2 38
198_Chapter 5_Pelvis, Hip, and Thigh
Figurę 5-66. Fulcrum test.
Trendelenburg#s Test. The Trendelenburg test is a
screening examination for weakness of the hip abductor muscles: the gluteus medius and the gluteus minimus. The pathomechanics of Trendelenburgs test have already been delineated in the section describing Trendelenburgs gait. To pcrform the Trendelenburg test, the examiner stands or sits behind the standing patient (Fig. 5-67A). The patient is then asked to lift each foot off the ground in tum. When the left foot is lifted, the right abductor muscles are being tested; when the right foot is lifted, the left abductor muscles are being tested. Normally, the abductors should be strong enough to allow the pelvis to remain level when a foot is lifted off the ground (Fig. 5-67B). Freąuently, the unsupported side actually rises slightly due to the normal contraction of the abductor muscles of the weight-bearing limb. If the abductors are weak, the pelvis droops toward the unsupported side when the foot is lifted from the ground (Fig. 5-67C). In cases of morę severe weakness, the patient is unable to lift the opposite foot without leaning sideways over the weight-bearing limb (Fig. 5-67D). This maneuver uses the same adaptation that produces the abductor lurch during gait.
The physical findings in common conditions of the pelvis, hip, and thigh are summarized in Table 5-1.
Figurę 5-67. Trendelenburgs test. A, Two-legged stanice. B, Normal single-leg stance.
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