Purpose: To test for ligamentous laxity or instability in the ankle. This test primarily assesses the strength of the Anterior Talofibular Ligament.
Test Position: Supine or Sitting.
Performing the Test: The examiner stabilizes the anterior distal leg with one hand & grasps the patient's calcaneus and rear foot with their second hand. The examiner then places the patient's foot into 10-15 degrees of plantar flexion and translates the rear foot anteriorly. A positive test results if the talus translates forward. Positive test results are often graded on a "0 to 3 scale", with 0 indicating no laxity & 3 indicating gross laxity.
Importance of Test: The anterior drawer test is a beneficial test to perform in a patient following an inversion ankle sprain (injury to the lateral collateral ligaments). The 3 main components of the Lateral Collateral Ligaments of the ankle include the anterior talofibular ligament (ATFL), calcaneofibular ligament, and posterior talofibular ligament. The ATFL courses from the anterior aspect of the lateral malleolus to the anterior medial aspect of the neck of the talus. The function of the ATFL is to resist anterior translation of the ankle and prevent internal rotation of the talus on the tibia. Based off the anatomical orientation, placing the ankle into 10-15 degrees of plantar flexion puts a stress on the ligament, which is enhanced when a posterior to anterior translation is applied. Because there is a subjective grading scale (0-3) for laxity, it is important for the novice clinician to critically assess the motion and patient's response during the test.
Note: these tests should only be performed by a properly trained health care practitioner.
Reference: Flynn , Timothy. Users' Guide to Musculoskeletal Examination. USA: Evidence in Motion, 2008. Print. Docherty, Carrie. "Reliability of the Anterior Drawer and Anterior Tilt Tests using the Ligmaster Joint Arthometer." 2009. Neumann, Donald. Kinesiology of the Musculoskeletal System. 2nd Edition.