Homans Sign for Deep Vein Thrombosis

hello everyone this is Paul from ortho eval pal and today I want to demonstrate how to perform the holmen's test for a DVT or how do I identify a DVT better when you are suspicious i doing Homans test on everybody who has lower extremity surgery or anybody who has had or been stagnant for a long period of time maybe they've been on a long trip and they flew for six hours or they've been in a car for a long time maybe they were hospitalized and in bed for a long time so I test this on many many patients and I think it's very important we have identified people who have had deep vein thrombosis and oftentimes it's due to lack of activity some people are higher risk of developing a DVT and so it's important that you test this and you test it correctly okay so the way you perform the Homans test is you take the patient I like to leave the leg in a little bit of a flexion and I'll explain that in a second you take the ankle and you Dorsey flicks a little bit and you squeeze the calf okay it would give them some discomfort right down the central aspect of the calf usually the calf is usually hot it's usually red and swollen compared to the other side okay you may see some gross swelling all the way down into the foot and ankle the reason I don't like to straighten the leg all the way when I do this is because if they are really really tight in the gastroc soleus and/or the hamstring region they're gonna get some discomfort from doing this and some people are just myofascial e sensitive the other problem is that if they are having sciatica or nerve root compression from the lumbar spine they could be getting some pain going down the leg and you can misinterpret that from dvt discomfort all right so it's very important that you feel legs to see if they're warmer than the other look for swelling look for redness and some tenderness deep in the center of the calf with palpation and discomfort with dorsiflexion and squeezing of the calf so this is the Homans test right here but I make sure that I test all of these other things if you are slightly suspicious and you are on the fence about sending a patient to the hospital for a Doppler all just send them okay it's much better to be safe than sorry on this particular situation the last thing you need is somebody to develop a pulmonary embolism and then you've missed it so if you are suspicious of that make sure that you send them the other thing you need to remember is that if they've been in something like a full leg immobilizer and they're propelling themselves with their foot all the time they may just have muscular discomfort so if they don't have a lot of redness and it's not hot and it's not swollen but more like muscle soreness it's take a look at their gait and see if maybe that's a contributing factor so that is the Homans test if you have any questions or would like to make any comments please make sure you leave them in our comment section underneath this video and I hope that you like the videos please subscribe to our Channel and if you have any questions please let me know thanks

Channel: Ortho Eval Pal with Paul Marquis PT

Views: 513,377

Keywords: Homan sign, Homans sign, DVT, Deep Vein Thrombosis, Homens sign, Homen's sign, Lower leg pain, blood clots, Physical Therapy exam, lower extremity vascular, how to perform a Homans sign, how to perform a homans test

Id: oz8bsSqxL8w

Length: 3min 1sec (181 seconds)

Published: Thu Aug 15 2019