Hip contracture Hip internal rotation contracture 2023-07-18T17:59:08Z The inability to rotate the proximal or upper limb segment laterally past anatomic neutral moving away from the midline, when viewed from anteriorly. Anatomic neutral position is defined as the trans-epicondylar axis of the distal humerus (for upper extremity) or femur (for lower extremity) is parallel to the sagittal plane of the body. This type of contracture is characterized by a turning of the knee from a neutral position to one facing more the midline, where the neutral position for the hip is with knee pointing directly anteriorly (less than or equal to 45 degrees).