Anterior Drawer of the Ankle
Original Editor - Staci Burns
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Purpose
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The purpose of this test was to determine whether ankle mechanical instability or hypermobility in the sagital plane of the talo-crural joint (or upper ankle joint) is present.
Technique
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The patient is supine, the knee joint is in 20° of flexion, the heel is resting on the palm of the examiners hand that is resting on the table hereby stabilizing the calcaneus. The examiner pushes the tibia (and fibula) posteriorly observing the amount of posterior translation of the tibia and fibula at the lateral aspect of the ankle and the change in endfeel. . The amount of posterior translation and the eventual weakening of the endfeel, changing from hard ligamentous to weak elastic is observed and is most indicative of a partial rupture or complete rupture of the anterior talofibular ligament. The test is graded on a 4-point scale. 0 represents no laxity and 3 represents gross laxity.
Evidence[edit | edit source]
Anterior drawer has sensitivity of 86 percent and specificity of 74 percent for a diagnostic test of 160 patients with an inversion ankle sprain when compared to an arthrogram. The +LR .22 and -LR .0018.
Resources[edit | edit source]
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Recent Related Research (from Pubmed)[edit | edit source]
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References
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van Dijk C, et al. Physical Examination is sufficient for the diagnosis of sprained ankles. J Bone Joint Surg. 1996;78-B:958-962.
