Fulcrum Test | Femoral Shaft Stress Fracture

Execution:

  1. Patient is sitting on the treatment bench and asked to lean backwards with his upper body
  2. The examiner places his forearm distally under the thight to be tested with his hand resting on the other thigh
  3. With the other hand the examiner presses down gently on the distal part of the femur
  4. In case no symptoms are reproduced, the forearm is moved more proximal and the procedure is repeated

 

Positive Outcome: Sharp pain and likely apprehension along the thigh

 

Study

Reliability Sn Sp LR+

LR-

Reiman et al. (2015)

NA

88-93 13-
75
1.17-7.15

0.92-0.09

Comment: Given the variable LR- of between 0.92-0.09, the Fulcum Test is only moderately sensitive to exclude Stress Fracturs of the Hip