Hip
Fractures / Osseous
Evidence: confirmed
Fulcrum Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Detecting Femoral Shaft Stress Fractures.
How to Perform
- Position: Patient sits on the edge of the bed.
- Action: Examiner places their forearm under the patient's thigh (acting as a fulcrum) and applies downward pressure on the knee.
Interpretation of Results
- Positive Test: Sharp pain or apprehension when the fulcrum is directly under the fracture site.
Clinical Context & Limitations
The Fulcrum Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Hip region, combining the Fulcrum Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment.
