Lower Limb Alignment
Reference lines and positions:
If measurements are to be taken, accurate bisections or reference lines have to be drawn. This is possibly one of the reasons for the wide range of inconsistencies and subjective nature that are seen in clinical measurements. Major sources of error may be the drawing of skin marks .
For drawing of bisections, measurement of positions and motion when the patient is prone, the posterior aspect of the calcaneus should be in the frontal plane – usually the leg needs to be internally rotated. This can be done by raising the hip with a pillow or having the patient assume the figure ‘4’ position (extremity not being examined is flexed at the knee, abducted at the hip and crossed over the posterior aspect of the knee of the extremity being examined internally rotates limb being examined.