Hip Lab

Question 1

What are the components of hip observation?
A) General
B) Sagittal View
C) Anterior/Posterior View

Answer 1

A) Symmetry, muscle bulk, bruising, scaring.
B) Pelvic alignment (Plumb line, Pelvic tilt)
C) Symmetry, relative height (PSIS, ASIS, gluteal folds, iliac crest), signs of hip rotation (squinting patella, femoral neck alignment).

Question 2

How is the Weber-Barstow Manoeuvre performed?

Answer 2

Used prior to leg length measurement to achieve a standardized position.

1. Pt in supine active flex both knees.
2. Therapist stabilize ankles on the plinth.
3. Pt lifts pelvis up and down in a controlled manner.
4. Legs passively extended by the therapist.

Question 3

How is Leg Length measured?

What is a significant discrepancy?

Answer 3

Pt in supine using a tape measure. ASIS to lateral malleolus of the same leg. OR ASIS to the medial malleolus of the same leg.

Visual Scan to Assess for Inequalities of Femur or Tibia Length
Femur: Pt in supine, hip and knees are passively flexed to 90 degrees. Skyline view of the patella is used to assess for inequality.
Tibia: Pt lies prone, knees passively flexed to 90 degrees by the therapist. Skyline view of the calcaneus is used to asses for inequality.

> 2cm difference may be relevant.

Question 4

Transfer Procedure for THR

Answer 4

A) Contraindications: Hip flexion past 90, Hip IR, Hip Adduction for 6 wks. Demonstrate on unaffected side. Give pt concrete examples. Check for understanding.

B) Steps:

1. Plan the environment.
2. Determine pt willingness to move and LOC. Explain how transfer will proceed.
3. Determine pt’s height and adjust the walker. Explain how to use the walker.
4. Put on the pt’s shoes. Ask about pain medication. Place IV line and folly catheter.
5. Adjust the height of the bed and the head rest. Get pt to come to the edge of the bed on the affected side.
6. Have pt support upper body w/ arms outreached behind them.
7. Communicate w/ pt about turning towards the affected side w/ pt supporting the leg.
8. Take a break to make sure pt is okay to stand up.
9. Push w/ one hand on bed to stand up. Therapist supports pt under the arm and back.
10. Take a few steps then return to bed.