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Surgical Notes

  • Clinical
    • General Approach
    • Superficial lesions
    • Orthopaedics and Neurosurgery
      • General
      • Lower Limb
        • Club Foot / Talipes
        • Gait
        • Hallux Rigidus
        • Hallux Valgus
        • Hammer / Mallet / Claw Toes
        • Hip examination / Osteoarthritis of the hip
        • Ingrowing toenail
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        • Osteochondroma
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        • Poliomyelitis
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      • Upper limb
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Home | Surgical Notes | Clinical | Orthopaedics and Neurosurgery | Lower Limb

Gait

Approach

  • Expose lower limbs
  • Remove shoes and socks
  1. Inspect
    • Patient walks towards you, turn backwards, walk back
    • Note inability to initiate movement (Parkinsons)
    • Grimaces for pain?

Completion

  1. Examine hip and back joints
  2. Trendelenburg test
  3. Measure leg lenghts
  4. Examine lower limb neurology

 

 

Phases of gait

  1. Heel strike
  2. Stance (foot on ground, centre of gravity moves forwards)
  3. Toe off (foot begins to lift off ground from the heel forward)
  4. Swing (foot moves forward while the contralateral

Abnormalities of gait

Type Description Reason for abnormality
Antalgic Decreases stance and increased swing phase Pain
Trendelenburg Hip dips instead of rises Abductor weakness
Parkinsonian Small festinant shuffles PD
Broad based Lurches to one side Cerebellar lesions
Short leg Ipsilateral hip drops when weight is on short leg Short leg
High stepping   Foot drop
Spastic Jerky, scissoring of legs Upper motor neurone

 

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