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External Rotation Test
Purpose: To help identify a tibiofibular syndesmotic injury (high ankle sprain).
Test Position: Supine or Sitting.
Performing the Test: The examiner maintains ankle dorsiflexion and externally rotates the foot on a stabilized leg. A positive test occurs when pain in recreated in the area over the interosseous membrane (syndesmosis region).
Diagnostic Accuracy: Sensitivity: .20; Specificity: 84.5
Importance of Test: The term "high ankle sprain" refers to an isolated injury to the tibiofibular syndesmosis. Syndesmotic sprains occur in about 10-20% of all ankle sprains. The stability of the syndesmosis in dependent on the surrounding bones and ligaments, in particular the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL), interroseous ligament, and the inferior transverse ligament. Normal motion of the tibiofibular syndesmosis is 1 to 1.25 mm with dorsiflexion of the talus. When the ligamentous stability of the syndesmosis is altered the motion can significantly increase and creates a mechanical instability.
Note: these tests should only be performed by a properly trained health care practitioner.
Test Position: Supine or Sitting.
Performing the Test: The examiner maintains ankle dorsiflexion and externally rotates the foot on a stabilized leg. A positive test occurs when pain in recreated in the area over the interosseous membrane (syndesmosis region).
Diagnostic Accuracy: Sensitivity: .20; Specificity: 84.5
Importance of Test: The term "high ankle sprain" refers to an isolated injury to the tibiofibular syndesmosis. Syndesmotic sprains occur in about 10-20% of all ankle sprains. The stability of the syndesmosis in dependent on the surrounding bones and ligaments, in particular the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL), interroseous ligament, and the inferior transverse ligament. Normal motion of the tibiofibular syndesmosis is 1 to 1.25 mm with dorsiflexion of the talus. When the ligamentous stability of the syndesmosis is altered the motion can significantly increase and creates a mechanical instability.
Note: these tests should only be performed by a properly trained health care practitioner.
References: Flynn , Timothy. Users' Guide to Musculoskeletal Examination. USA: Evidence in Motion, 2008. Print.
Cesar, Paulo. "Comparison of Magnetic Resonance Imaging to Physical Examination for Syndesmotic Injury After Lateral Ankle Sprain ." American Orthopaedic
Foot and Ankle Society. 32.2 (2011): n. page. Web. 23 Sep. 2012.
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