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Evaluating for Syndesmotic injury
e
• 2 Tests for injury to th
syndesmosis
– The Squeeze test
– External rotation test
Anterior Drawer test
• For integrity of capsule and
anterior talofibular ligament
• Pulling the heel
anteromedially against
resistance applied by the
other hand over anterior
aspect of lower leg
• Anterior subluxation of 3
mm of talus is pathological
Test for rupture of tendo-Achilles
Thompson test
• Prone position with feet
projecting beyond
examining table
• Calf muscle squeezed
• Normal or partially torn-
planter flexion
• Complete rupture- No
movement of foot
Test for rupture of tendo-Achilles
Needle test
• For integrity of distal 10 cm of
tendo-achillles
• Prone position
• 25 G hypodermic needle
pierced through skin at 10 cm
above upper end of calcaneum
and just medial to midline of
calf
• Foot passively plantiflexed and
dorsiflexed
• Normal- needle swivel in
direction opposite to
movement of foot
Test for pre-achillles and post
achilles pathologies
• Pt asked to walk on toes
with heel off the ground-
pain in pre achilles
pathology
• Walk on heel- pain in post
achilles pathology
• Achilles tendinitis – pain in
both mode of walking, more
on walking on toes
Ankle Dorsiflexion Test
• Todetermine whether
gastronimius or soleus
causing limitation of ankle
dorsiflexion
• With flexion of the knee
joint, ankle dorsiflexion
achieved – Gastronemius
• Not affected by flexion of
knee- Soleus

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2 Evaluating for Syndesmotic injury.pptx

  • 1. Evaluating for Syndesmotic injury e • 2 Tests for injury to th syndesmosis – The Squeeze test – External rotation test
  • 2. Anterior Drawer test • For integrity of capsule and anterior talofibular ligament • Pulling the heel anteromedially against resistance applied by the other hand over anterior aspect of lower leg • Anterior subluxation of 3 mm of talus is pathological
  • 3.
  • 4. Test for rupture of tendo-Achilles Thompson test • Prone position with feet projecting beyond examining table • Calf muscle squeezed • Normal or partially torn- planter flexion • Complete rupture- No movement of foot
  • 5. Test for rupture of tendo-Achilles Needle test • For integrity of distal 10 cm of tendo-achillles • Prone position • 25 G hypodermic needle pierced through skin at 10 cm above upper end of calcaneum and just medial to midline of calf • Foot passively plantiflexed and dorsiflexed • Normal- needle swivel in direction opposite to movement of foot
  • 6. Test for pre-achillles and post achilles pathologies • Pt asked to walk on toes with heel off the ground- pain in pre achilles pathology • Walk on heel- pain in post achilles pathology • Achilles tendinitis – pain in both mode of walking, more on walking on toes
  • 7. Ankle Dorsiflexion Test • Todetermine whether gastronimius or soleus causing limitation of ankle dorsiflexion • With flexion of the knee joint, ankle dorsiflexion achieved – Gastronemius • Not affected by flexion of knee- Soleus