Dr. Kevin Yip

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

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PASSIVE TESTS-Passive flexion

Positioning.

The subject lies relaxed in the supine position. The examiner stands level with the hip.

Procedure.

Both hands lift the knee upwards towards the subject’s chest until the movement stops. Meanwhile a slight axial pressure is applied
on the femur.

Common mistakes:

• Moving the thigh too much laterally towards the shoulder.
• Carrying the movement too far, beyond the range where the tilt of the pelvis starts. This is precluded by sufficient axial pressure.

Alternative technique:

one hand can be placed under the pelvis in order to detect the start of the
pelvic tilt.

Normallunctional anatomy:

• Rat/ge: 110-130°
• Elld-fee/: ligamentous
• LimitiNg structures:

– posterior part of the joint capsule
– muscles of the buttock
– contact between labrum and neck.

Common pathological situations:

• Too hard an end-feel on passive flexion is one
of the first signs of an osteoartmosis.
• In advanced arthrosis this movement is markedly limited. Typically the femur moves laterally when the flexion is forced.
• In children this abduction movement during flexion is often the first manifestation of Perthes’ disease.

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