TESTS
POSITION OF THE ANKLE
STRUCTURES INVOLVED
DESCRIPTION OF TEST BEING PERFORMED
MOUSE OVER PICTURE TO VIEW MOVIE
Eversion Stress
Medial Stress
Neutral plantarflexion to eversion
Deltoid Ligament
Knee is bent 900 and gastrocnemius is relaxed. The heel is held from below by one hand while the other hand holds the lower leg. The hand on the heel is placed somewhat inferior medial and is used to push the calcaneus and talus into eversion while the other hand grips the lower leg laterally and pushes medially.
Side to Side Test
Transverse
Drawer Test
Neutral plantarflexion
Anterior and Posterior
Inferior Tibiofibular Ligaments
Interosseous Membrane
Knee is flexed 900 and gastrocnemius is relaxed. Move the calcaneus and talus to each side as a unit. Do not tilt the ankle. If mortise is widened, the talus will be able to move sideways, producing a definite thud as it hits the fibula, and when moved in the opposite direction, it butts against the tibia.
Anterior Drawer
Slight plantarflexion
Anterior Talofibular Ligament
Anteromedial Capsule
Knee is flexed 900 and gastrocnemius is relaxed. One hand holds the lower tibia and exerts a slight posterior force, and the other hand is around the posterior aspect of the calcaneus and attempts to bring the calcaneus and talus forward on the tibia. Also done by stabilization of foot and talus on table and pushing tibia and fibula posteriorly.
Inversion Stress
Lateral Stress
Neutral Plantarflexion
200 Plantarflexion
Calcaneofibular Ligament
Calcaneofibular Ligament and Anterior Talofibular Ligament
Knee is flexed 900 and gastrocnemius is relaxed. The heel is held from below by one hand while the other hand holds the lower leg. The hand on the heel is placed somewhat inferior lateral and is used to push the calcaneus and talus into inversion while the other hand grips the lower leg medially and pushes laterally. Note an end point.
External Rotation Test
Kleiger Test
From neutral to external rotation of foot
Anterior Inferior Tibiofibular Ligament
Interosseous Membrane
Foot should be in neutral position with the lower leg stabilized. Examiner should then externally rotate the foot. If this causes pain then must consider a tear of the anterior tibiofibular ligament. Depending on severity the interosseous membrane may be involved. Pain will be at site of the anterior tibiofibular ligament.
Squeeze Test
Below head of fibular
Anterior Inferior Tibiofibular Ligament
Perform the squeeze test just above the anterior tibiofibular ligament. Squeeze the bones together firmly and slowly, hold and then quickly release. If there is pain upon release at the area of the anterior tibiofibular ligament, then a sprain of that ligament is highly suspected.
Squeeze Test
Up and down the shaft of the tibia and fibula. Foot is in a neutral, relaxed position.
Testing for fracture of tibia or fibular.
Place the heel of each hand at equal height on the shaft of the tibia and fibula, then push or squeeze the bones together. Pain above or below the sight of the squeeze is indicative of a fracture. Test should be repeated several times up and down the shafts of both bones.
Heel Tap Test
Foot is relaxed and in a neutral position
Tibia and Fibula
The foot is held relaxed by one hand in a somewhat neutral position, while the heel of the other hand is used to tap or lightly hit the bottom of the heel from an inferior to superior direction. Pain along the lower leg may indicate a fracture of the tibia or fibula.