Ankle Special Tests

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Ligamentous Instability

Anterior drawer test, Talar tilt

Miscellaneous

Homans' sign, Thompson test, Tibial torsion test, True leg length discrepancy test

Anterior drawer test

The patient is positioned in supine. The therapist stabilizes the distal tibia and fibula with one hand, while the other hand holds the foot in 20 degrees of plantar flexion and draws the talus forward in the ankle morise. A positive test is indicated by excessive anterior translation of the talus away from the ankle mortise and may be indicative of an anterior talofibular ligament sprain.

Talar tilt

The patient is positioned in sidelying with the knee flexed to 90 degrees. The therapist stabilizes the distal tibia with one hand while grasping the talus with the other hand. The foot is maintained in a neutral position. The therapist tilts the talus into abduction and adduction. A positive test is indicated by excessive adduction and may be indicative of a calcaneofibular ligament sprain.

Homans sign

The patient is positioned in supine. The therapist maintains the leg in extension and passively dorsiflexes the patient's foot. A positive test is indicated by pain in the calf and may be indicative of deep vein thrombophlebitis.

Thompson test

The patient is positioned in prone with the feet extended over the edge of a table. The therapist asks the patient to relax and proceeds to squeeze the muscle belly of the gastrocnemius and soleus muscles. A positive test is indicated by the absence of plantar flexion and may be indicative of a ruptured Achilles tendon.

Tibial torsion test

The patient is positioned in sitting with the knees over the edge of a table. The therapist places the thumb and index finger of one hand over the medial and lateral malleolus. The therapist then measures the acute angle formed by the axs of the knee and ankle. Normal lateral rotation of the tibia is considered to be 12-18 degrees in an adult.

True leg length discrepancy test

The patient is positioned in supine with the hips and knees extended and the legs 15-20 cm apart with the pelvis in balance with the legs. Uisng a tape measure the therapist measures from the distal point of the anterior superior iliac spines to the distal point of the medial malleoli. A positive test is indicated by a bilateral variation of greater than one centimeter and may by indicative of a true leg length discrepancy.

Ankle Special Tests

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