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Anterior Drawer Test Ankle

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Other Names

  • Anterior Drawer of the Ankle

Purpose

Anterior Drawer Test for the Ankle
Clinical demonstration of anterior drawer test of the ankle[1]

Description

  • Patient is seated with feet hanging or supine
  • The heal is placed in the palm of the examiners hand
    • Foot should be in 10-15° of plantarflexion
  • The examiner then translates the calcaneus anteriorly
  • A positive exam is greater than 1 cm of translation compared to the healthy ankle
    • There may be a poor end feel
    • Graded on a scale of 0 (no laxity) to 3 (gross laxity)

Pathology


Evidence

Lateral Ankle Sprain

  • Van Dijk et al prospective, blinded study of 160 patients injured within 48 hours of exam[2]
    • Sensitivity: 96%
    • Specificity: 84%
  • Phisitkul et al cadaveric study of 10 ankles[3]
    • Sensitivity: 75%
    • Specificity: 50%
  • Blanchard et al prospective study of 142 patients examined within 5 days, 216 health controls[4]
    • Sensitivity: 32%
  • Croy et al prospective study of 66 patients with a history of lateral ankle sprain[5]
    • Sensitivity: 74-83%
    • Specificity: 38-40%
  • Fujii et al cadaveric study of 6 ankles by 5 blinded examiners[6]
    • Sensitivity: 60%
    • Specificity: 74%

See Also


References

  1. McGovern, Ryan P., and RobRoy L. Martin. "Managing ankle ligament sprains and tears: current opinion." Open access journal of sports medicine 7 (2016): 33.
  2. van Dijk CN, Lim LSL, Bossuyt PMM, Marti RK. Physical Examination is sufficient for the diagnosis of sprained ankles. J Bone Joint Surg. 1996; 78-B: 958-962.
  3. Phisitkul, Phinit, et al. "Accuracy of anterolateral drawer test in lateral ankle instability: a cadaveric study." Foot & ankle international 30.7 (2009): 690-695.
  4. Blanshard, K. S., et al. "A radiological analysis of lateral ligament injuries of the ankle." Clinical radiology 37.3 (1986): 247-251.
  5. Croy, Theodore, et al. "Anterior talocrural joint laxity: diagnostic accuracy of the anterior drawer test of the ankle." journal of orthopaedic & sports physical therapy 43.12 (2013): 911-919.
  6. Fujii, Tadashi, et al. "The manual stress test may not be sufficient to differentiate ankle ligament injuries." Clinical biomechanics 15.8 (2000): 619-623.
Created by:
John Kiel on 12 July 2019 00:33:03
Authors:
Last edited:
24 March 2023 07:10:36
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