Anterior Drawer

• Passive

• Tests Anterior Talo-Fibular Ligament

• Technique

  • Patient seated with lower leg relaxed and hanging off table

  • Examiner in front of patient

  • Examiner grasps the lower leg above the ankle with one hand and the heel/hindfoot with the other

  • While stabilizing the tibia the foot is pulled anteriorly

  • A positive result occurs when there is excessive anterior translation and/or pain, especially when compared with the unaffected side

  • A negative result is when there is no increased translation or pain with the maneuver

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Posterior Drawer

• Passive

• Tests Posterior Talo-Fibular Ligament

• Technique

  • Patient seated with lower leg relaxed and hanging off table

  • Examiner in front of patient

  • Examiner grasps the lower leg above the ankle with one hand and the dorsal mid foot with the other

  • While stabilizing the tibia the foot is pushed posteriorly

  • A positive result occurs when there is excessive posterior translation and/or pain, especially when compared with the unaffected side

  • A negative result is when there is no increased translation or pain with the maneuver

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Talar Tilt

• Passive

• Tests Calcaneo-Fibular Ligament

• Technique

  • Patient seated with lower leg relaxed and hanging off table

  • Examiner in front of patient

  • Examiner grasps the lower leg above the ankle with one hand and the heel/hindfoot with the other

  • While stabilizing the tibia the foot is inverted

  • A positive result occurs when there is excessive inversion of the hindfoot and/or pain, especially when compared with the unaffected side

  • A negative result is when there is no increased inversion laxity or pain with the maneuver

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Kleiger Maneuver

• Passive

• Tests Tibia-fibular Ligaments and syndesmosis

• Technique

  • Patient seated with lower leg relaxed and hanging off table

  • Examiner in front of patient

  • Examiner grasps the lower leg with one hand and the mid and forefoot with the other

  • While stabilizing the tibia the foot is externally rotated

  • A positive result occurs when there is external rotation/tibio-fibular widening and/or pain, especially when compared with the unaffected side

  • A negative result is when there is no increased laxity or pain with the maneuver

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Squeeze Test

• Passive

• Tests Tibia-Fibular Ligaments and syndesmosis

• Technique

  • Patient seated with lower leg relaxed and hanging off table

  • Examiner in front of patient

  • Examiner firmly squeezes the proximal portion of the lower leg with both hands "squeezing" the fibula and tibia together

  • A positive result occurs when the maneuver elicits pain distally

  • A negative result is when there is no pain with the maneuver

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Thompson Test

• Passive

• Tests Achilles tendon integrity

• Technique

  • Patient prone with the knee flexed to 90°

  • Examiner on the patient's affected side

  • Examiner grasps and squeezes the calf

  • A positive result occurs when the foot does not plantarflex when the calf is squeezed

  • A negative result is when the foot plantarflexes symmetric to the opposite extremity

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