Telescopy

Name of test

Telescopy

What it tests

Differentiate intracapsular from extracapsular fracture of the femoral neck

How to do it

• Place the patient in the supine position.
• Flex his/her affected hip and knee at a 90-degree angle, keeping the hip slightly adducted.
• If the left is the affected side, hold the left femur with your left hand and put your right hand alongside the trochanter to appreciate excursion (movement of the trochanter toward the ilium). You would put your right hand on the right femur and place your left hand alongside the trochanter if the right side were affected.
• Apply axial pressure along the line of the femur proximally. If the test is abnormal, you will feel significant excursion around 4 to 5 cm.
• Repeat the test a few times to confirm whether it is normal or abnormal.

The normal response

No exaggerated movement of the greater trochanter

What it means if not normal

• Femoral neck fracture
• Posterior dislocation of the hip
• Congenital hip dislocation
• Paralytic abductor musculature
• Trochanteric fracture nonunion

The test name, telescopy, refers to the old tube-within-tube telescopes, where the capsule of the hip is the outer tube and the base of the femoral neck is the inner tube. If there is no connection between the acetabulum and the base of the femoral neck, the test will be positive – ie, sliding of two tubes in relation to each other.

Comments

Never attempt the telescopy test in a patient with a fresh fracture; it will cause severe pain. This test is used primarily to confirm findings of a previous femoral neck fracture.

Citations

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