A Standard Trendelenburg Test

from: Hardcastle & Nade. JBJS(B): 67-B(5):741-6

As a result of our observations, we have formulated a standard method of performing the Trendelenburg test; if this is used the response can be interpreted in a clinically meaningful way. To perform the test properly does take time, and its accurate assessment demands the full understanding and co-operation of the patient.

 How to do the test

1.  The examiner stands behind the patient and observes the angle between the pelvis (the line joining the iliac crests) and the ground (Fig. 7).

2.  The patient is asked to raise from the ground the foot of the side not being tested, holding the hip joint at between neutral and 30 of flexion. The knee should be flexed enough to allow the foot to be clear of the ground in order to nullify the effect of the rectus femoris muscle. The position of the pelvis is again noted (Fig 8) A supporting stick can be used in the hand only on the side of the weight-bearing hip; alternatively, both shoulders can be supported by the examiner so as to maintain balance without a stick (Fig. 12).

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