Stress Tests for Ankle Ligaments

Anterior Drawer Test

Assesses: the stability of the anterior talofibular ligament (ATFL).

The examiner exerts a downward force on the tibia while simultaneously attempting to “lift up” the foot while grasping behind the heel. A significant difference from the unaffected side (>2 mm) or dimpling of the anterior skin (suction sign) is considered positive.

Talat Tilt Test

anterior drawer and talar tilt test

The patient is positioned in sitting or supine lying with the knee in full extension. The examiner stabilizes the distal leg with one hand while the other hand holds the heel with the ankle:

a. Assess Anterior talofibular ligament: Plantar flexion – inversion

b. Assess Calcaeno-fibular ligament: Neutral position – inversion

c. Assess Posterior talofibular ligament: Dorsiflexion – inversion

d. Assess Deltoid ligament: Plantar flexion – eversion

e. Assess Syndesmotic (high ankle) sprain: Dorsiflexion – eversion

Squeeze Test

Assesses: Tibiofibular syndesmotic injuries

The examiner grasps the patient’s leg midway up the calf and performs a compress and release motion. A positive test is considered if the patient experiences pain in the area of the syndesmosis.

Thompson Test

Assesses: Integrity of Achilles tendon

The examiner squeezes the calf with the patient prone. If the foot does not plantar flex, the test is positive for Achilles tendon disruption.

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