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Physical Exam for Ankle Sprains

- See: Talar Tilt

- Anterior Drawer Test
    - evaluates Anterior Talofibular ligament (look for diff. of 8 mm)
    - this can be performed by securing distal leg w/ one hand and applying an anterior pull on the heel with the foot held in gentle plantar flexion;
    - forward shift of more than 8 mm on a lateral radiograph is considered diagnostic for an ATFL tear;
    - distance measured between posterior lip of tibia & nearest part of talus reflects anterior subluxation of the talus;

- Eversion test;
    - in neutral evaluates superficial deltoid ligament complex;

- Inversion (Supination) test
    - w/ ankle in plantarflexion: evaluates anterior talofibular ligament;
    - in neutral / sl. dorisflexion: evaluates calcaneofibular ligament;

- Misc:
    - Assessment of Peroneal Muscle Strength;
    - Amount of Ankle Dorsiflexion;

- Grading of Injuries

- Grade I:
    - stable injuries involving stretching or partial tearing of anterior talofibular ligament;

- Grade II:
    - complete tear of the ATFL with vary degrees of injury to the CFL
    - positive anterior drawer and negative talar tilt test;

- Grade III:
    - involve complete or near complete tears of both the ATFL and CFL;
    - positive anterior drawer and positive talar tilt test