Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Passive external rotation

Positioning.

The subject lies in the supine position with the hip and knee bent to 90°. The
examiner stands level with the subject’s hip. One hand supports the lower leg just above the ankle, the other hand is put at the knee and stabilizes the femur in a vertical position.

Procedure.

Rotate the lower leg inwards, meanwhile assuring the vertical position of the femur, until the movement comes to a soft stop.Observe the anterior iliac spine of the opposite side to detect the start of a lateral pelvic tilt.

Common mistakes.

The leg is pushed beyond the possible range, which causes a lateral tilt of
the pelvis.

Normallunctional anatomy:

• Range: 60-90°
• End-feel: ligamentous
• Limitillg strllctures:

– superior part of the iliofemoral ligament
– pubofemoral ligament
– tensor fasciae latae and gluteus minim us.

Common pathological situations:

• This movement can be extremely painful and / or limited in psoas bursitis, trochanteric bursitis and in the presence of internal derangement in the hip.
• Children with a slipped epiphysis may present with an increased range of external rotation.
• In arthrosis the external rotation is usually the last movement to become disturbed.

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