Trendelenburg's sign is found in people with weak or paralyzed abductor muscles of the

hip In vertebrate anatomy, the hip, or coxaLatin ''coxa'' was used by Celsus in the sense "hip", but by Pliny the Elder in the sense "hip bone" (Diab, p 77) (: ''coxae'') in medical terminology, refers to either an anatomical region or a joint on t ...

, namely

gluteus medius The gluteus medius, one of the three gluteal muscles, is a broad, thick, radiating muscle. It is situated on the outer surface of the pelvis. Its posterior third is covered by the gluteus maximus, its anterior two-thirds by the gluteal aponeuros ...

and

gluteus minimus The gluteus minimus, or glutæus minimus, the smallest of the three gluteal muscles, is situated immediately beneath the gluteus medius. Structure It is fan-shaped, arising from the outer surface of the ilium, between the anterior and infe ...

. It is named after the German surgeon

Friedrich Trendelenburg Friedrich Trendelenburg (; ; 24 May 184415 December 1924) was a German surgeon. He was son of the philosopher Friedrich Adolf Trendelenburg, father of the pharmacologist Paul Trendelenburg, the physiologist Wilhelm Trendelenburg and of the pol ...

. It is often incorrectly referenced as the Trendelenburg test which is a test for vascular insufficiency in the lower extremities.

Signs and symptoms

The Trendelenburg sign is said to be positive if, when standing on one leg (the 'stance leg'), the pelvis severely drops on the side opposite to the stance leg (the 'swing limb'). The muscle weakness is present on the side of the stance leg. If the patient compensates for this weakness by tilting their trunk/thorax to the affected side, then the pelvis will be raised, rather than dropped, on the side opposite to the stance leg. Ergo, in the same situation, the patient's hip may be dropped or raised, dependent upon whether the patient is actively compensating or not. Compensation shifts the center of gravity to the affected side, and also decreases the angle between the hip adductor muscles and femur, both of which decrease the forces needing to be applied by the hip adductor muscles to maintain relevant posture. The gluteus medius is very important during the stance phase of the gait cycle to maintain both hips at the same level. One leg stance accounts for about 60% of the gait cycle, and during the stance phase, there is approximately three times the body weight transmitted to the hip joint. The hip abductors' action accounts for two thirds of that body weight. A Trendelenburg sign can occur when there is presence of a muscular dysfunction (weakness of the gluteus medius or minimus) or when someone is experiencing pain.

Causes

A positive Trendelenburg's sign is caused by weakness or ineffective action of the abductor muscles of the

lower limb Lower may refer to: *Lower (album), ''Lower'' (album), 2025 album by Benjamin Booker *Lower (surname) *Lower Township, New Jersey *Lower Receiver (firearms) *Lower Wick Gloucestershire, England See also

*Nizhny {{Disambiguation ...

, the gluteus medius muscle and the gluteus minimus muscle. * Damage to the motor nerve supply of the lateral gluteal muscles (gluteus medius muscle and gluteus minimus muscle) **

Polio Poliomyelitis ( ), commonly shortened to polio, is an infectious disease caused by the poliovirus. Approximately 75% of cases are asymptomatic; mild symptoms which can occur include sore throat and fever; in a proportion of cases more severe ...

involving L5 (foot drop may also be seen because L5 innervates the

tibialis anterior muscle The tibialis anterior muscle is a muscle of the anterior compartment of the lower leg. It originates from the upper portion of the tibia; it inserts into the medial cuneiform and first metatarsal bones of the foot. It acts to dorsiflex and invert ...

). ** Damage to the

superior gluteal nerve The superior gluteal nerve is a mixed (motor and sensory) nerve of the sacral plexus that originates in the pelvis. It provides motor innervation to the gluteus medius, gluteus minimus, tensor fasciae latae; it also has a cutaneous branch. Str ...

. * Temporary or permanent weakness of the lateral glutei ** Tendinitis. ** Penetrating injury. ** Infection, abscess – blood borne, post-traumatic or post-surgical. * Ineffective action (insufficient leverage) of the lateral glutei ** Greater trochanteric avulsion. ** Fracture, (or non-union) of the femoral neck. **

Coxa Vara Coxa vara is a deformity of the hip, whereby the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This results in the leg being shortened and the development of a limp. It may be congenital and is commonly ...

(the angle between the femoral neck head and shaft is less than 120 degrees). * Damage to the hip joint (fulcrum) - Chronic or Developmental Hip Dislocation/Dysplasia ** Osteonecrosis. ** Legg-Calve-Perthes disease. ** Developmental dysplasia. ** Chronic infection. ** Uncorrected traumatic dislocation.

References

External links

Trendelenburg Test at GPNotebook
{{Orthopedic examination , state=autocollapse Athletic training Symptoms and signs: musculoskeletal system Eponyms in medicine