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Ankle Special Tests
| Question | Answer |
|---|---|
| Neutral subtalar positioning purpose | Identifies abnormal rearfoot to forefoot positioning |
| Neutral subtalar positioning description | Pt prone with foot over edge of table. Palpate dorsal aspect of talus on both sides with 1 hand, and grasp lateral forefoot with other hand. Gently dorsiflex foot until resistance then gently move food through arc of supination of pronation |
| Neutral subtalar positioning result | Neutral position is here you feel foot fall off easier to one side or other. At this point compare rearfoot to forefoot to leg |
| Anterior drawer test purpose | Identify ligamentous instability (particularly anterior talofibular ligament) |
| Anterior drawer test description | Pt lies supine with foot relaxed. Examiner stabilizes tibia and fibula, holds pt's foot in 20 degrees of PF, and draws the talus forward in ankle mortise |
| Anterior drawer test result | positive test if talus has excessive anterior glide/pain is noted |
| Talar tilt test purpose | To identify instability of calcaneofibular ligament |
| Talar tilt test description | Pt lies supine or sidely with foot relaxed. Pt' gastroc m may be relaxed by flexion of knee. Foot is held in anatomical 90 degree position, talus is then tilted side to side into inversion and eversion. |
| Talar tilt test result | Inversion tests the calcaneofibular ligament. Eversion stresses the deltoid ligament |
| External Rotation Stress Test (Kleiger test) purpose | Evaluates syndesmosis injury and a tear of the deltoid ligament. |
| External Rotation Stress Test (Kleiger test) description | Pt is seated with leg handing over examining table with knee at 90. Examiner stabilizes leg with 1 hand. With other hand, examiner holds foot in plantigrade (90) and applies passive lateral rotation stress to the foot and ankle |
| External Rotation Stress Test (Kleiger test) result | Test positive for syndesmosis (high ankle) injury if pain is produced over anterior/posterior tibiofibular ligaments and the interosseous membrane. Pain present medially, & examiner feels the talus displace from medial malleolus: tear of deltoid lig. |
| Squeeze test of the leg purpose | Assess syndesmosis integrity |
| Squeeze test of the leg description | Pt lies supine. Examiner grasps lower leg at midcalf and squeezes tibia and fibula together. Examiner applies he same load a more distal locations moving toward the ankle |
| Squeeze test of the leg results | Pain in lower leg may indicate syndesmosis injury, provided that fracture, contusion, and compartment syndrome have been rule out. |
| Thompson's test purpose | Evaluates integrity of Achilles tendon |
| Thompson's test description | Pt lies prone or knees on chair with feet over edge of table/chair. While pt is relaxed, examiner squeezes the calf muscles. |
| Thompson's test result | Absence of PF when muscle if squeezed indicates a positive test and a ruptured Achilles tendon (3rd degree strain) |
| Tinel's sign purpose | Identifies dysfunction of posterior tibial nerve |
| Tinel's sign description | Anterior tibial branch of deep peroneal nerve may be percussed in front of the ankle. Posterior tibial nerve may be percussed as it passes behind the medial malleolus |
| Tinel's sign result | In both cases, tingling/paresthesis felt distally is a positive sign |
| Morton's test purpose | Identifies stress fracture or neuroma in forefoot |
| Morton's test description | Pt lies supine. Examiner grasps the foot around the metatarsal heads and squeezes the heads together |
| Morton's test result | Pain positive for stress fracture or neuroma |
Created by:
ecosio
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