Ankle Orthopaedic Test: Talar Tilt

The Talar tilt test is a diagnostic test used to evaluate the stability of the ankle joint, specifically the lateral ligaments of the ankle. The test involves inversion stress testing of the ankle to assess the degree of laxity or instability present.

Here's a step-by-step procedure in bullet form:

1. Position the patient seated or lying on an examination table, with the leg to be tested hanging over the edge of the table.
2. Place one hand on the lower leg just above the ankle to stabilize the tibia.
3. Grasp the heel with the other hand and tilt the foot and ankle inward, or into inversion.
4. Apply a firm, yet gentle, pressure to the medial aspect of the foot to tilt the talus bone laterally.
5. Observe the degree of movement of the talus bone.
6. Compare the degree of movement on the affected ankle to the unaffected ankle, if possible.
7. If there is excessive lateral movement of the talus bone or pain is reproduced, it is considered a positive test for instability.
8. Repeat the test on the other ankle if necessary.

References:

1. Magee, D. J. (2014). Orthopedic Physical Assessment-E-Book. Elsevier Health Sciences.
2. Hoppenfeld, S., & Murthy, V. (2018). Physical examination of the spine and extremities. Wolters Kluwer.
3. Kannus, P., Renstrom, P., & Johnson, R. J. (Eds.). (2007). Practical Orthopaedic Sports Medicine and Arthroscopy. Lippincott Williams & Wilkins.
4. van Dijk, C. N., Lim, L. S., Bossuyt, P. M., & Marti, R. K. (1996). Physical examination is sufficient for the diagnosis of sprained ankles. Journal of Bone and Joint Surgery-British Volume, 78(6), 958-962.
5. Bullock-Saxton, J. E. (1994). Local sensation changes and altered hip muscle function following severe ankle sprain. Physiotherapy Theory and Practice, 10(4), 179-186.
6. Eechaute, C., Vaes, P., Duquet, W., & Van Gheluwe, B. (2009). The Talar tilt test: a review of the literature and new insights into its clinical utility. Sports Medicine, 39(8), 663-676.