Ankle & Foot Competency Flashcards
What 3 tests can be done to test the ligaments of the ankle/foot?
Anterior drawer test Talar tilt Eversion test
How do you perform an anterior drawer test for the ankle?
Grasp posterior calcaneus with one hand and distal tibia/fibula with the other hand, monitoring anteriorly at the anterior talus. Provide anterior force on calcaneus while stabilizing the distal tibia/fibula. Normal springing of calcaneus back to neutral
should occur.
• (+) Test: Pain, no springing, excessive motion/laxity
• Indication: ATF ligament pathology/tear (lateral ankle
sprain)
How do you perform a talar tilt test?
Grasp distal tibia/fibula with one hand and inferior calcaneus with the other, blocking motion of the calcaneus on the talus. Invert the talus to evaluate ROM.
• (+) Test: Laxity, increased ROM, or pain
• Indication: Calcaneofibular ligament pathology/tear, also
tests some ATF (lateral ankle sprain)
How do you perform an eversion test of the ankle?
Grasp distal tibia/fibula with one hand and plantar surface of the
mid-foot with the other hand. Evert the foot to evaluate ROM.
- (+) Test: Laxity, increased ROM or pair
- Indication: Deltoid ligament pathology (medial ankle sprain)
How do you perform a squeeze test of the ankle?
Wrap hands around leg proximal to the ankle, contacting distal
tibia/fibula with both thenar eminences. Squeeze for 2-3
seconds, then rapidly release.
- (+) Test: Pain at syndesmosis
- Indication: Syndesmosis pathology (high ankle sprain)
How do you perform a cross leg test?
Patient crosses affected ankle over opposite knee. Apply pressure to distal fibula of affected leg
- (+) Test: Pain at distal ankle
- Indication: Syndesmosis pathology (high ankle sprain)
How do you perform a thompson test?
Patient prone with foot off the table. Squeeze the patient’s calf.
Observe for plantarflexion.
- (+) Test: Absence of plantar flexion
- Indication: Achilles tendon rupture
How do you perform a Homan’s sign test?
Patient laying or seating with knee extended. Dorsiflex the patient’s foot. Can apply lateral compression to calf
- (+) Test: Pain with dorsiflexion
- Indication: thrombophlebitis or acute deep vein thrombosis (DVT)
Can also observe accompanying signs of edema, erythema, and warmth of lower leg. Would need to order a Venous Doppler to rule out clot
(Not always performed clinically due to potential risk of
embolus)
What in conjunction with a positive Homan’s sign increases suspicion for DVT?
Unilateral swelling and redness of calf
How do you perform a moses sign test?
Patient seated or supine with knee slightly flexed or extended. Induce an anterior compression on the gastrocnemius muscle into the posterior aspect of the tibia (compresses the calf towards the tibia).
- (+) Test: Pain with anterior compression
- Indication: Deep vein thrombosis of the posterior tibial veins
(Not always performed clinically due to potential risk of
embolus)
What type of ankle sprain accounts for 80-85% of all ankle sprains?
Ankle inversion with plantar flexion **Swelling and ecchymosis over the involved area. Both are more prevalent with increasing severity of injury**
What are the 3 major ligaments involved in an inversion ankle sprain?
- Anterior talofibular
- Calcaneofibular
- Posterior talofibular
What are the movements that cause a high ankle sprain?
Eversion and rotation (some dorsiflexion)
Where is the pain commonly in a high ankle sprain?
Medial side - Minimal swelling or ecchymosis - Pain with weight bearing **Most common in football and downhill skiing**
What ligaments are involved in a high ankle sprain?
Anterior inferior tibiofibular ligament and syndesmosis
