Shoulder Orthopaedic Test: Anterior Drawer Test Of The Shoulder

The Anterior Drawer Test of the Shoulder is a physical exam technique used to assess for anterior shoulder instability. Here is a step-by-step procedure for performing the test:

1. Have the patient sit or lie supine on an examination table with their shoulder relaxed and in a neutral position.
2. Stand next to the patient's affected side and stabilize the scapula by placing one hand on the superior border of the scapula and the other hand on the clavicle.
3. Grasp the patient's elbow with your other hand and position the shoulder in 90 degrees of abduction and slight external rotation.
4. Place your thumb anteriorly over the patient's humeral head to palpate for any anterior displacement.
5. While maintaining the patient's arm in 90 degrees of abduction and slight external rotation, apply an anterior force to the humeral head.
6. Observe the amount of anterior translation or subluxation of the humeral head in relation to the glenoid.
7. Assess the amount of laxity or "sponginess" of the joint, as well as the patient's level of pain or discomfort.
8. Repeat the test on the opposite shoulder for comparison.
9. If there is excessive anterior translation or subluxation of the humeral head or if the patient experiences pain or discomfort, further diagnostic testing or referral to a specialist may be necessary.

A normal result of the Anterior Drawer Test of the Shoulder is the absence of anterior translation or subluxation of the humeral head. This means that the humeral head remains in place in the glenoid fossa and there is no laxity or "sponginess" of the joint.

References:

1. Magee, D. J. (2014). Orthopedic Physical Assessment. Elsevier Health Sciences.
2. Chen, A. L., Ong, B. C., & Rose, D. J. (2009). Anterior shoulder instability: a review of clinical evaluation and imaging. Radiologic clinics, 47(4), 617-633.
3. Park, H. B., Yokota, A., & Gill, H. S. (2004). Elongation of the anterior capsule and the superomedial portal in shoulder arthroscopy for anterior instability. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 20(12), E101-E106.
4. Walch, G., Boulahia, A., Calderone, S., & Robinson, A. H. (1998). The ‘dropping’and ‘hornblower’s’signs in evaluation of rotator-cuff tears. Journal of Bone and Joint Surgery, 80(4), 624-628.