Ankle Special Tests Flashcards
Anterior Drawer Test: response and implications
Checking ATFL (Anteior Talofibular ligament) 85% of the time that is the ligament that is injured
Kleiger Test: response and implications
Deltoid. This is a corroborative test with the valgus stress test
Anterior Impingement Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours.
Perform Test: Take proximal hand and put thumb right in area right above the sinus Tarsi. with your distal hand all you are going to do is dorsiflex the ankle.
Kleiger Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours.
Perform Test: Take proximal hand and put thumb right in area right above the sinus Tarsi. Take your distal hand and grab over the dorsum of the mid foot. The thumb should be in the cuboid and the fingers on the navicular. Now go ahead and do an eversion stress test at the mid foot, which is pulling on the deltoid ligament. This is a corroborative test with the valgus stress test.
Varus Stress Test: response and implications
CFL (calcaneofibular ligament – The second most commonly injured ligament in the ankle)
Anterior Drawer Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours. Use distal hand and grab under the calcaneus and take proximal hand and put it over the distal tib-fib. Their foot needs to be resting on the volar surface of your forearm.
Perform Test: pull anteriorly to check the ATF. What you are trying to do is pull the talus out of the mortise.
Valgus Stress Test: response and implications
Deltoid ligament
Anterior Impingement Test: response and implications
Pain indicates a positive test
Scar Tissue from repeated sprains is implicated
Posterior Drawer Test: response and implications
PTFL (Posterior Talofibular Ligament – rarely injured - the third of three to be injured)
Valgus Stress Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours. Use distal hand and grab under the calcaneus and take proximal hand and put it over the distal tib-fib. Their foot needs to be resting on the volar surface of your forearm.
Tilt the leg in to frontal plain valgus/eversion (remember valgus is a frontal plane movement at the STJ [subtalar joint])
Compression Test: how to perform
Pt in dependent position. You are sitting on lateral side of leg.
Swing your chair around now facing your partner’s leg, and start up at the proximal tib-fib. This should be about 3 or 4 compression distractions. The finally compression and distraction needs to be around the malleoli.
Shuck Test: response and implications
Tests the Ankle Capsule. It is a generic test that is not very good
Other name for Shuck Test
Cotton Test
Other name for Cotton Test
Shuck Test
External Rotation Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours.
Perform test: This is probably the hardest one to do.
Take your distal hand and put it underneath the calcaneus and put your forearm on the medial side of the foot. Take your proximal elbow and put it on the lateral side of your partner’s leg and your hand should be stabilizing over the distal tibia. Now go ahead and dorsiflex the ankle first and then hold the dorsiflexion and externally rotate the ankle. It won’t move very much because that is the closed packed position and what you are doing is forcing the talus to splay the fibula apart and that would be indicative of a diastasis or a syndesmotic injury to distal tib-fib (high ankle sprain). If there were a diastasis injury then this would hurt.
Posterior Drawer Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours. Use distal hand and grab under the calcaneus and take proximal hand and put it over the distal tib-fib. Their foot needs to be resting on the volar surface of your forearm.
Push straight posteriorly to test the PTFL (posterior Talofibular Ligament, this is hardly ever injured)
Compression Test: response and implications
Fracture or MTSS (medial tibial stress fracture)
If it hurts it could be shin splints, periostitis, fractures, etc.
You start all the way up near the fibular head which checks for a Maisonneuve fracture
Your last compression should be at the malleoli, and right above that is where you can get the Pott’s fracture.
When you compress it you are checking for a fracture and when you let go (the distraction phase) then that usually checks distally for a diastasis or syndesmotic injury. If the compression feels better and then you release it hurts then that is a positive for the diastasis or syndesmotic injury because as you release the mortise splays open which hurts.
That is a corroborative test external rotation test.
Varus Stress Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours. Use distal hand and grab under the calcaneus and take proximal hand and put it over the distal tib-fib. Their foot needs to be resting on the volar surface of your forearm.
Tilt the leg in to frontal plain varus/inversion (remember varus is a frontal plane movement at the STJ [subtalar joint])
Calcaneal Tap Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg.
Relax your top side hand and take your bottom hand and give 3 calcaneal taps.
You hit the bottom of the calcaneus to try and elicit a vibration. (Some people use tuning forks and a variety of different things.)
You are checking to see if it shows up a Pott’s fracture a Maisonneuve Fracture or a Jones Fracture. A positive is pain in the patient.
Calcaneal Tap Test: response and implications
Stress Fractures
You are checking to see if it shows up a Pott’s fracture a Maisonneuve Fracture or a Jones Fracture. A positive is pain in the patient.
Shuck Test: how to perform
Starting position: pt sitting in dependent position. Sit on lateral side of patient’s leg. Can put pt’s leg right on yours. Use distal hand and grab under the calcaneus and take proximal hand and put it over the distal tib-fib. Their foot needs to be resting on the volar surface of your forearm.
Perform Test: push side to side without tilting. It is a generic test that is not very good, but described in the literature.
External Rotation Test: response and implications
Distal Tib-Fib Lig.
what you are doing is forcing the talus to splay the fibula apart and that would be indicative of a diastasis or a syndesmotic injury to distal tib-fib (high ankle sprain). If there were a diastasis injury then this would hurt.
