Positive Trendelenburg’s sign is seen in all EXCEPT:
Correct Answer: Paralysis of gluteus Maximus
Description: Paralysis of gluteus Maximus REF: Essential Clinical Anatomy, Keith .L. Moore 4th edition p.348/354 See APPENDIX-3 for list of "Gait abnormalities"Repeat in June 2010A positive Trendelenburg test is found in:Any condition that brings the origin and inseion of gluteus medius together:Subluxation or dislocation of the hipCoxa varaGreater trochanter fracturesSlipped upper femoral epiphysisFracture neck of femurAbductor paralysis or weakness e.g.:PolioNerve root lesionSuperior gluteal nerve damageMuscle-wasting diseaseAny painful hip disorder which results in gluteal inhibitionPositive Trendelenburg's sign due to Injury to Superior Gluteal Nerve:The Trendelenburg's sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in unilateral superior gluteal nerve injury, when the patient lifts the opposing leg, the shift is not created and the patient cannot maintain balance leading to instability. Bilateral superior gluteal nerve injury results in a waddling gaitNOTE:Not to be confused with Trendelenburg's sign. TheTrendelenburg Test or Brodie-Trendelenburg test is a test which can be carried out as pa of a physical examination to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins
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