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From the end of the bed, check for scars and if there is an obvious flexion deformity, and look for symmetry.
- In fractured head of femur, one leg may be shortened and rotated externally.
Any obvious leg length discrepancy may be seen and can be checked for using a tape measure.
- Measurement should be taken from a fixed point
- Such as the anterior superior iliac crest to the medial malleolus
- Both sides are compared
- A difference means a real leg length discrepancy.
Palpate the greater trochanter for tenderness
Perform the following movements:
- Full flexion of the hip
- Full internal and external rotation
- Full flexion on one hip.
- If bad, the opposite leg will rise up.
- Stand on one leg, knee flexed. Do both legs. In a normal test, the hip will drop on the bent side.
Finally, ask Patient to walk.
- Look for waddling gait – sign of hip pain, or proximal muscle weakness