Buerger’s test (leg raise & capillary refill)

Definition:

Also referred to as the vascular angle, this test aims to gain some insight as to whether a patient way be suffering from ischaemia.

Test procedure:

The vascular angle, also known as Buerger’s angle, is the angle at which an individual’s leg has to be raised for it to start turning pale (blood draining).

With your patient lying supine, slowly raise their extended leg and note at which angle the patient’s toes become paler, holding the leg in position for approximately one minute. Repeat the procedure on both sides.

Test findings: Positive & negative

In a healthy patient, the toes should remain of a vivid colour, even when the limb is raised to ninety degree. In an ischaemic leg, as little as fifteen degrees of sustained elevation (approximately one minute) may cause pallor to ensue. A Buerger’s angle of less than twenty degrees is indicative of severe ischaemia.

 

Special considerations:

 It is also worth noting that when descending the leg to its original position, in a patient suffering from arterial disease, the leg will revert to its original colour more slowly than normal.