What Is The Anterior Drawer Test Ankle?
The purpose of the anterior drawer test ankle is to test the ankle instability or ligamentous laxity in the ankle joint. In the ankle, there are 3 lateral collateral ligaments calcaneofibular ligament, anterior talofibular ligament, and posterior talofibular ligament.
Ankle anterior drawer test mainly assesses the stability/firmness of the anterior talofibular ligament. It is the weakest ligament on the lateral side. The anterior talofibular ligament originates from the anterior aspect of the lateral malleolus of the fibula and then passes anteromedially and finally attaches to the lateral part of the talus (at the neck of the talus).
The main function of the anterior talofibular ligament is to restrict the anterior displacement of the talus. It also limits adduction and inversion at the subtalar joint.
Generally, injury occurs due to a fall or misstep during walking or sports-related activities. Most commonly, injury occurs due to rapid inversion and adduction at the ankle and subtalar joint of the foot.
Procedure for Performing Anterior Drawer Test Ankle
- Ask your patient to lie down in a supine position.
- Place the patient’s ankle joint into 20° of plantar flexion. Now with one hand, stabilize the anterior aspect of the distal leg (distal tibia and fibula).
- After that, cup the palm of another hand and grasp the patient’s calcaneus, and attempt to bring the calcaneus anteriorly detecting the total amount of anterior translation in the lateral part of the ankle as well as the difference in the end feel.
What is the Positive Anterior Drawer Test Ankle?
The examiner will feel an increase in anterior translation (greater than 1 cm) compared to the unaffected side as well as excessive laxity (looseness) and eventual weakening of the end feel, and these signs could signal a positive anterior drawer test ankle.
Therefore, a positive anterior drawer at the ankle indicates a partial or complete rupture of the anterior tibiofemoral ligament. The anterior drawer test ankle positive results are graded on a 3-point scale. 0 means no laxity & 3 indicates gross (heavy) laxity (looseness).
When the Ankle Anterior Drawer Test Is Considered Negative?
The anterior drawer test ankle is considered negative when ligament laxity on both sides is equal, which means the patients didn’t suffer from the anterior talofibular ligament tear.
Importance of Anterior Drawer Test Ankle
| First Interval | Second Interval | |
|---|---|---|
| Sensitivity | 74% | 83% |
| Specificity | 38% | 40% |
Van Dijk et al. (1996) assessed 160 patients in a period of five days (acute condition) following an inverted injury. They discovered a sensitivity of 96% and a specificity of 84% for a rupture of the anterior talofibular ligament.
Therefore, it seems that the anterior drawer test ankle includes a higher clinical value to find a ligament rupture in an acute condition but plays quite weak for chronic laxity.
Related Article
Knee Test
Anterior Drawer Test of the knee
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Hello Friends,
My self Ritvik Verma and I am a Physiotherapist and the founder of www.physio-study.com. I completed my bachelor’s of physiotherapy from Integral University Lucknow and an internship at KMC Hospital Meerut.
Then I worked in the Physiotherapy Department of Lovee Shubh Hospital (Lucknow) for one year. Then I joined Holistic Touch Physical Therapy & Wellness Clinic and worked there for more than six months.
I am running my clinic and writing blogs on my website, www.physio-study.com, in my hometown, Lakhimpur Kheri.
