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Woods David; Macnicol, Malcolm
Journal of Pediatric Orthopaedics B: July 2001
Hip: PDF Only


This report introduces the flexion-adduction test as an additional diagnostic technique for hip pathology in children and young adults. Losses of flexion-adduction, internal rotation, abduction and total flexion arc are all individually assessed in patients with confirmed hip pathology. The findings suggest that the “flexion-adduction” test is a simple, but sensitive, clinical procedure to detect the early signs of hip disease in older children and young adults. Although abduction and internal rotation are reportedly the most commonly restricted movements in frequent hip pathologies such as irritable hip, Legg-Calvé-Perthes disease and slipped epiphysis, we believe that the loss of flexion-adduction is often the first affected range of movement. A statistical analysis of 87 cases from 1994 to 1997 is presented wherein the clinical loss of flexion-adduction provided the initial suggestion of underlying hip pathology, and concludes that the loss of internal rotation, abduction and flexion arc are not statistically reliable tests for clinically diagnosing pathology individually. Often, despite a positive flexion-adduction test, the other ranges of movements remained unaffected or minimally affected in children and young adults with varying hip diseases, later confirmed through subsequent physical examinations or investigations. A through explanation of the flexion-adduction test is provided.

*Royal North Shore Hospital, St Leonards, NSW, Australia; and †Royal Hospital for Sick Children, Edinburgh UK

Address correspondence and reprint request to Malcolm Macnicol, Consultant Orthopaedic Surgeon, Royal Hospital for Sick Children, Sciennes Road, Edinburgh, EH9 1LF.

© 2001 Lippincott Williams & Wilkins, Inc.