Template:Special Test
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Purpose
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To examine the ankle for injury of the Anterior Talofibular ligament and the Calcaneofibular ligament.
Technique
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Patient is seated with foot and ankle unsupported. The foot is positioned in 10-20 degrees of plantarflexion. The distal lower leg is stabilized with one hand just proximal to the malleloi and the hindfoot is inverted with the other hand. The lateral aspect of the talus is palpated to determine if tilting occurs. The laxity is compared to the contralateral side. [1] [2]
Evidence
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- Extracted from Orthopedic Physical Examination Tests: An Evidence-Based Approach: "Medial Talar Tilt Stress Test": Hertel et al. Sensitivity 67, Specificity 75, LR+ 2.7, LR- 0.44. Cite error: Invalid
<ref>tag; name cannot be a simple integer. Use a descriptive title - Johannsen, A. 1978. Acta Orthopaedica. Radiological diagnosis of lateral ligament lesion of the ankle: a comparison between talar tilt and anterior drawer sign.
In a prospective study of 244 patients with ankle lesions a comparison between the talar tilt and the anterior drawer sign was made, leading to the following conclusions: Ligament lesions which are not disclosed by the talar tilt examination may be diagnosed by the anterior drawer sign. The anterior drawer sign cannot replace the talar tilt examination, or vice versa. The two methods are complementary. It is not possible to differentiate between an isolated lesion of the anterior talofibular ligament and a combined lesion of the anterior talofibular and the calcaneofibular ligaments by the two methods.
- Gaeblerl C, Kukla C, Breitenseher MJ, Nellas ZJ, Mittlboeck M, Trattnig S, and Vecsei V. 1997 Act Orthopaedica. Diagnosis of lateral ankle ligament injuries: comparison between talar tilt, MRI and operative findings in 112 athletes.
We evaluated the reliability of the radiographic talar tilt test by MRI examinations in 11 2 athletes with injuries to the lateral ligaments of the ankle. 25 athletes with a talar tilt z 15" were treated operatively. lntraoperative findings and the talar tilt test were compared with MR imaging results. Our results suggest that MRI is a reliable method for diagnosing injuries of the lateral ankle ligaments. The talar tilt test cannot evaluate the specific pathology of lateral ankle ligaments, but it was reliable in indicating complete double-ligament ruptures (anterior talofibular and calcaneo-fibular ligaments), when talar tilt was 15" or more than on the uninjured side.
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References[edit source]
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- ↑ Cook CE and Hegedus EJ. Orthopedic Physical Examination Tests: An Evidence-Based Approach. Prentice Hall. New Jersey. 2007.
- ↑ Wheeless Online Textbook of Orthopaedics. Talar Tilt: Physical Exam. http://www.wheelessonline.com/ortho/talar_tilt_physical_exam
