Brodie–Trendelenburg Test

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Introduction

This technique was originally described in the in 1846 by Brodi an popularized by Trendelenburg in 1891. The primary aim of this test was to identify an incompetency in the sapenofemoral junction.

Technique

The affected leg is raised so that the veins are emptied by gravity. Around the upper thigh region a tourniquet is applied, sufficiently tightly to constrict the saphenous vien. The femoral vein blood flow is'nt obstructed. The subject is then asked to stand and the degree of filling of he saphenous vein is noted.

Interpretation

If the test is negative, with the tourniquet in place the veins fill within a period of 30 seconds, ad upon removal of the tourniquet n increased rate of filling is observed. There is no retrograde flow taking place through the saphenofemoral junction, and the filling occurs due to incompetency of the communicating veins.

If the test is positive, While the patient stands with a tourniquet is placed, the varicosities will remain collapsed throughout the 30second period. Once the tourniquet is removed the internal saphenous vein rapidly fills with blood from above. This indicates that the valves of the saphenous vein at the saphenofemoral junction are incompetent, but the valves of the communicating veins are still intact.

Doubly positive, If the veins rapidly fill on standing and again as the tourniquet is removed is there is further distension of the veins. This indicates incompetency of the valves of both the saphenous and communicating systems of veins.

If the test is negative, the tourniquet is applied and even after removal there is only slow filling of the veins from below. This indicates competency of both the saphenous veins and the communicating veins

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