Clinical Exam Ankle

Question 1

what type of joint is the ankle?

Answer 1

hinge joint

Question 2

what is the fork of the hinge called and what bones make it up?

Answer 2

tibia and fibula, plafond

Question 3

where do most ankle sprains occur and what ligament is involved?

Answer 3

lateral ankle, anterior talo-fibular ligament

Question 4

what is the medial ankle ligament called?

Answer 4

deltoid ligament

Question 5

what are the lateral ligaments of the ankle?

Answer 5

anterior talo-finular ligament, calcaneo-fibular ligament, posterior talo-fibular ligament

Question 6

in what foot position do most ankle sprains occur?

Answer 6

when person is up on toes (plantarflexion) because talus is unstable

Question 7

what is pes cavus?

Answer 7

high arch

Question 8

what is pes planus?

Answer 8

flat foot

Question 9

what are you palpating in the foot?

Answer 9

base of 5th metatarsal dorsally (Jones region)
bases of metatarsals 2-4 plantar aspect (Lis Franc injuries)
anterior navicular
medial tubercle of calcaneus (plantar fascia)
achilles insertion and mid-substance

Question 10

what are you palpating on the lateral ankle?

Answer 10

ATFL, CFL, PTFL
lateral malleolus (inferoposterior aspect)

Question 11

what are you palpating on the medial ankle?

Answer 11

deltoid ligament, medial malleolus (inferoposterior aspect)

Question 12

what are you palpating on the anterior ankle?

Answer 12

anterior syndesmosis (between tibia and fibula)

Question 13

what is normal plantarflexion?

Answer 13

40-50 degrees

Question 14

what is normal dorsiflexion?

Answer 14

15-20 degrees

Question 15

what is the thompson’s squeeze test?

Answer 15

tests for achilles tendon rupture

squeeze calf - reduced plantarflexion signifies rupture of tendon, normal plantarflexion signifies normal

Question 16

what does the anterior ankle drawer test test for?

Answer 16

ATFL integrity (not done in acute setting - pain invalidates test)

Question 17

what is the classic method for the anterior ankle drawer test?

Answer 17

patient has knee flexed at 90 degrees; stabilize tibia with one hand, use other hand to pull calcaneous anteriorly
normal: ankle move forward a few millimeters and then come to firm endpoint
positive test: excessive laxity

Question 18

what is the alternative method for the anterior ankle drawer test?

Answer 18

knee flexed at 90 degrees with foot resting on exam table
sit on patients foot to stabilize, use both hands to push distal tibia posteriorly on calcaneous
positive test: excessive laxity

Question 19

what is the talar-tilt/varus stress test?

Answer 19

it tests for CFL integrity
knee flexed at 90
one hand stabilizes distal tibia and other hand inverts foot until motion is stopped by CFL
positive test: excessive laxity