Hip Orthopaedic Test: Patellar-Pubic Percussion Test
May 31, 2023The PPPT is a simple bedside diagnostic tool that is sensitive in detecting clinically straight forward hip fractures as well as occult hip fractures. The PPPT can support decision-making for additional radiological examinations in case of potential occult pelvis or hip fractures.
Procedure for performing the Patellar-Pubic Percussion Test:
- Have the patient lie flat on their back on an examination table, with their legs extended.
- Locate the patella (kneecap) on the affected side.
- Locate the pubic symphysis (the joint where the two sides of the pelvis meet) and place one hand over it.
- Using the other hand, tap gently but firmly on the patella, while keeping the knee extended.
- Observe the patient's reaction: If the patient feels pain or discomfort in the hip during the tapping.
- Repeat the test on the other knee.
- To increase the sensitivity of the test, the clinician may try to elicit pain by using a tuning fork over the area.
As with any physical examination test, the results should be interpreted in conjunction with other assessment findings and patient history, and a definitive diagnosis may require further imaging or diagnostic testing.
References:
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Smeets, S.J.M., Vening, W., Winkes, M.B. et al. The patellar pubic percussion test: a simple bedside tool for suspected occult hip fractures. International Orthopaedics (SICOT) 42, 2521–2524 (2018). https://doi.org/10.1007/s00264-018-4036-2
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