Trendelenburg

Trendelenburg refers to a medical position and related clinical signs named after German surgeon Friedrich Trendelenburg. In its primary form, the patient lies on the back (supine) on a table that is tilted so that the head is lower than the feet, producing a head-down tilt. A reverse Trendelenburg position is the opposite, with the head raised relative to the feet. The position is used in certain surgical and emergency scenarios to improve exposure or to redistribute body contents, though its routine use for shock has diminished due to potential adverse effects.

In surgery, the Trendelenburg position can improve visualization of the lower abdomen and pelvis by moving abdominal contents toward the diaphragm. It may aid venous return in some contexts but can worsen respiratory function and intracranial pressure. It is used selectively and with careful monitoring of airway, ventilation, and cardiovascular status. In obstetrics and anesthesia, it has been used historically to treat hypotension after spinal or epidural anesthesia, but evidence and guidelines favor other measures.

The Trendelenburg sign, or Trendelenburg test, is a clinical assessment of hip abductor strength. The patient stands on one leg; a positive sign occurs when the pelvis drops on the side opposite the stance leg, indicating weakness of the stance leg's gluteus medius and minimus, often due to superior gluteal nerve injury. A Trendelenburg gait may also develop, producing a characteristic lateral trunk sway during walking.