Posterior Drawer Test |
Examination type |
Joint
Instability |
Patient & Body Segment Positioning |
The patient
should be laying supine on a table. The patient should be
completely relaxed throughout the test. |
Examiner Position |
The examiner
should stand behind the patient at the patient’s head. The
examiner should then place one hand on the patient’s involved
shoulder with the heel of the hand on the clavicle, the fingers
on the spine of the scapula, and the thumb on the coracoid
process. The other hand should grasp the forearm of the
involved side. |
Tissues
Being Tested |
This test is
for posterior instability of the glenohumeral joint &
ligamentous laxity.Muscles and tendons of the rotator cuff,
posterior labrum, ligamentous structures of the shoulder,
posterior shoulder capsule |
Performing the Test |
The examiner
should the hand grasping the forearm move the patient’s arm into
80-1200 abduction, 80-1200 of elbow
flexion, 20-300 of horizontal abduction. The examiner
then should use place the thumb of the hand stabilizing the
scapula over the head of the humerus. While making sure to
stabilize the scapula, the examiner will then proceed to
internally rotate the forearm and push in a posterior direction
on the humeral head with the thumb. |
Positive Test |
Translation
or subluxaion/luxation of the humeral head; Apprehension |
Interpretation |
A positive
test indicates instability, not necessarily injury. A little
translation is normal in most people. As the humerus translates
more, there is a problem with stability. Translation can be
moderate, mild, or severe. |
Common errors in
performing exam |
In many
cases, hand placement is the most common error. Many forget to
stabilize the scapula, and many cannot find the humeral head to
test for instability. |
Factors possibly
resulting in misinterpretation |
The tensing
of the muscles by the patient so that the test cannot be
performed properly can result in misinterpretation as well as
forgetting to stabilize the scapula and having the scapula
rotate while performing the test. |
Related tests |
Load & Shift
Test, Posterior Apprehension of Stress Test, Norwood Stress Test
for Posterior Instability, Posterior Instability (Horizontal
Adduction/Abduction) Test, Push-Pull Test, Jerk Test, Posterior
Dislocation Test (Neer & Walsh), Prone Posterior Drawer Test |
References |
Prentice,
William E. (2003). Arnheim’s Principles of Athletic Training
A Competency-Based Approach. U.S.A.: McGraw-Hill Companies,
INC.
Magee.
Orthopedic Physical Assessment. 4th Ed. 2002. |
Links: |
http://www.fpnotebook.com/ORT121.htm
http://www.maitrise-orthop.com/corpusmaitri/orthopaedic/88_gagey/gageyus.shtml
http://www.hope.edu/academic/kinesiology/athtrain/program/studentprojects
/Ldornbos2/shoulder/sld085.htm |
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