Ankle Orthopaedic Test: Anterior Drawer of the Ankle

The anterior drawer test is a physical examination technique used to evaluate the stability of the ankle joint, specifically the anterior talofibular ligament (ATFL). 

1. Have the patient lie down on their back with their knee bent and their foot flat on the examination table.

2. Grasp the patient's heel with one hand and their foot with the other hand.

3. Stabilize the patient's leg with your forearm.

4. With your other hand, pull the patient's foot forward, as if you were trying to slide the ankle joint forward.

5. Observe the amount of forward movement of the ankle joint and feel for any excessive looseness or instability.

6. Compare the results to the unaffected ankle, if possible.

If there is excessive forward movement of the ankle joint, this may indicate a sprain or tear in the anterior talofibular ligament. However, it is important to note that the anterior drawer test should be used in conjunction with other examination techniques and diagnostic tests to accurately diagnose ankle injuries.

References:

These references provide additional information on the anatomy and pathomechanics of ankle stability, as well as other clinical tests and evaluation techniques used in conjunction with the anterior drawer test.

1. Magee, D. J. (2014). Orthopedic Physical Assessment (6th ed.). Elsevier Saunders.
2. Clarkson, H. M. (2000). Musculoskeletal Assessment: Joint Motion and Muscle Testing (2nd ed.). Lippincott Williams & Wilkins.
3. Hertel, J. (2002). Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability. Journal of Athletic Training, 37(3), 364–375. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC164354/

These references provide additional information on the diagnostic accuracy of the anterior drawer test for ankle ligament injuries and its use in clinical practice.

1. van Dijk CN, Lim LS, Bossuyt PM, Marti RK. Physical examination is sufficient for the diagnosis of sprained ankles. J Bone Joint Surg Br. 1996;78(6):958-962. PMID: 8949083.
2. Rowe SA, Dickey JP 2nd, Herring SA. The reliability of the anterior drawer test for the assessment of the ankle. J Orthop Sports Phys Ther. 1993;17(2):162-170. doi: 10.2519/jospt.1993.17.2.162. PMID: 8438724.
3. Kerkhoffs GM, Rowe BH, Assendelft WJ, et al. Immobilisation and functional treatment for acute lateral ankle ligament injuries in adults. Cochrane Database Syst Rev. 2002;(3):CD003762. doi: 10.1002/14651858.CD003762. PMID: 12137619.