ankle special tests Flashcards
neutral position of the talus- weight bearing
purpose: find neutral position of the talus
pt. pos: standing
prac. pos: kneeling behind pt., finger on navicular bone on medial foot
procedure: pt. instructed to slowly invert or roll the foot out and then slowly evert the foot. very slowly the pt. inverts the foot until the practitioner feels the navicular bone become flush with the talus and calcaneous
positive: a pronated or supinated foot. lots of movement compared to neutral position for navicular
Fick Angle “too many toes” Sign
purpose: postural evaluation for symmetry
pt. pos: standing
prac. pos: sitting or standing behind pt.
procedure: the number of visible toes is noted. sit back behind standing pt. look for toes on the side to see which side we can see more toes
positive: inequality. may be indicative of retroversion, or kneor tibia or foot pathology
anterior drawer test for ankle- modified
purpose: test anterior tala-fibular ligament and/or osteochondral issues
pt. pos: sitting on table with leg extended or with knees flexed to 90 degrees and hanging off table
prac. pos: at foot of pt. one hand stabilizing distal leg and other cups the heel while pt.’s leg rest on the forearm of practitioner
procedure: begin by scouring the talus then perform the anterior drawer.
positive: excessive movement, pain, crepitus or popping
talar tilt
purpose: integrity of anterior talo-fibular, calcaneo-fibular or posterior talo-fibular ligaments
pt. pos: supine, foot hanging off table
prac. pos: at foot of pt. one hand on distal leg and other on calcaneus
procedure: stabilized the distal leg, invert and evert the calcaneus.
positive: pain, excessive laxity, crepitus
plantar flexion= atfl
neutral= calcaneo-fibular ligament
dorsiflexion= talo-fibular ligaments
Homan’s sign
purpose: deep vein thrombosis
pt. pos: siting on the end of table
prac. pos: at foot of pt. hand on distal leg or heel
procedure: foot is passively dorsiflexed and knee extended
positive: pain, particularly in the mid-calf
thompson test
purpose: achilles tendon rupture
pt. pos: prone on table
prac. pos: at foot of pt. hand on mid calf
procedure: squeeze belly of gastrocnemius
positive: normal= plantar flexion
abnormal= no foot movement
compression test/ squeeze test
purpose: fracture of fibula or syndesmosis
pt. pos: sitting on table with legs supported
prac. pos.: at side of pt. hands interlaced and placed on proximal tibia
procedure: prac. squeezes at the proximal tibia/fibula and moves distally
positive: pain distal to the squeeze site
tap test/ percussion test
purpose: fracture of the tibia or talus
pt. pos: sitting on table with legs hanging slightly off
prac. pos.: at foot of pt.
procedure: heel is struck with the prac.’s palm
positive: radiating pain through tibia or on talus
tinel test
purpose: nerve involvement
pt. pos: sitting on table with legs supported
prac. pos.: standing at foot of pt.
procedure: one finger is used to tap on anterior of foot (anterior tibial nerve) or behind medial malleolus (posterior tibial nerve)
positive: shooting pain or numbness distal to tapping
Morton’s test
purpose: Morton’s neuroma or metatarsal fracture
pt. pos: sitting no table
prac. pos.: at foot of pt. hand is placed over metatarsals
procedure: heads of metatarsals are lined up and then squeezed together
positive: numbness, tingling, shooting pain or nerve, crepitus, pain for fracture
wedge test
purpose: problems with syndesmosis or distal tibio-fibular ligament, also done for dome of talus fracture
pt. pos: sitting on table with legs slightly off table
prac. pos.: at foot of pt., one hand on the pt.’s foot
procedure: foot is taken into dorsiflexion and then compressed into talo-crural joint. (push calcaneus straight toward hip of pt.)
positive: pain along the tibia/ fibula margin, crepitus or pain on talus
proximal tibiofibular test
purpose: laxity at the proximal tibio-fibular joint
pt. pos: sitting or supine on table
prac. pos.: next to pt. one hand on fibular head one hand on tibia
procedure: head of the fibula is moved in small increments in an anterior and posterior translation
positive: pain and laxity
capillary refill
purpose: determine vascularity
pt. pos: sitting or supine
prac. pos.: at foot of pt.
procedure: the toenail is compressed by the prac. and the nail bed should turn white, the color should return to pink when pressure is released
positive: cold feet, no change in color
pulse
purpose: determine vascularity
pt. pos: sitting or supine
prac. pos.: at foot of pt., two fingers placed on the anterior foot between the tendons of the 1 and 2nd metatarsals
procedure: pulse is taken
positive: decreased or absence of pulse
Weiss line
purpose: determine fallen arch (calcanei-navicular ligament sprain)
pt. pos: sitting then standing
prac. pos.: at foot of pt.
procedure: use marker to mark the 1st mp joint of the 1st metatarsal and medial malleolus. draw a line from two points. note where navicular lines in relation to the line. have the pt. stand while weight bearing, note if navicular has dropped lower
positive: navicular bone is well below the draw line
