Special Orthopedic Tests : Lower Leg, Ankle, Foot

Question 1

Anterior Drawer of the Ankle

Answer 1

Process :
1. Client supine with foot relaxed; examiner stabilizes tibia & fibula, holds client’s foot in 20 degree plantarflexion & draws talus forward
+ve Sign : Anterior translation, pain
+ve Indicates : Anterior talofibular ligament sprain

Question 2

External (Lateral) Rotation Stress Test (Kleiger Test)

Answer 2

Process :
1. Patient seated with leg hanging over table with knee 90 degrees
2. Examiner stabilizes leg with one hand, and with the other hand, holds foot plantigrade (90 degrees) and applies a passive lateral rotation stress to foot and ankle
+ve Sign : Pain produced over anterior or posterior tibiofibular ligaments and interosseous membrane
+ve Indicates : Syndesmosis (“high ankle”) injury

Question 3

Squeeze Test of the Leg

Answer 3

Process :
1. Client supine; examiner grasps lower leg at midcalf & squeezes tibia & fibula together, then applies same force at more distal locations moving toward the ankle
+ve Sign : Pain in lower leg
+ve Indicates : Syndesmosis sprain

Question 4

Talar Tilt Test

Answer 4

Process :
1. Client supine or sidelying with foot relaxed
2. Foot held in anatomical position (90 degrees)
3. Examiner tilts talus into adduction & abduction
+ve Sign : Pain, excessive movement
+ve Indicates :
Adduction - Calcaneofibular ligament sprain
Abduction - Deltoid ligament sprain

Question 5

Homan’s Sign

Answer 5

Process :
1. Examiner dorsiflexes client’s foot with knee extended & palpates calf
+ve Sign : Exquisite pain, tenderness with palpation
+ve Indicates : Deep vein thrombosis (DVT)

Question 6

Test for Peronal Tendon Dislocation

Answer 6

Process :
1. Process prone on the table knee flexed 90 degrees
2. Posterolateral region angle inspected for swelling
3. Patient asked to actively dorsiflex and plantarflex ankle along with eversion against resistance
+ve Sign : Tendon subluxes from behind the lateral malleolus
+ve Indicates : Peroneal tendon dislocation

Question 7

Thompson’s (Simmonds’) Test (Sign for Achilles Tendon Rupture)

Answer 7

Process :
1. Client prone, relaxed with feet over edge of table; examiner squeezes triceps surae
+ve Sign : Absence of plantarflexion
+ve Indicates : Achilles rupture / 3rd degree strain

Question 8

Windlass Test

Answer 8

Process :
1. Patient stands on a chair with foot positioned so the metatarsal heads rest on the edge of the stool, and patient maintains weight through the leg; examiner passively dorsiflexes the big toe
+ve Sign : Pain or increased pain at the insertion of the plantar fascia
+ve Indicates : Plantar fasciitis