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Paper Pull Out Test

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Other Names

  • Paper Pull Out Test
  • Paper Pull-Out Test


(A) before and (B) after paper pull out test. Note tearing is normal.[1]
  • Assess the strength of plantarflexion of the toes


  • A strip of paper (approximately 1 cm × 6 cm) is placed under the affected toe tip
  • While the patient plantar flexes the affected digit grasps the ground
    • The examiner pulls the paper strip out from beneath the toe
  • Positive test
    • The paper strip is pulled out intact without tearing.



  • Unknown

See Also


  1. Jastifer, James R., Jesse Doty, and Leif Claassen. "Current concepts in the treatment of metatarsophalangeal joint instability of the lesser toes: review, surgical technique, and early outcomes." Fuß & Sprunggelenk 15.4 (2017): 225-236.
Created by:
John Kiel on 31 January 2022 06:32:52
Last edited:
22 April 2023 23:20:27