Understanding the Anterior Drawer of the Ankle Assessment
To assess the integrity of the **Anterior Talofibular Ligament (ATFL)**, the most commonly injured ligament in lateral ankle sprains.
Watch How It's Done
How do I start?
Patient is supine or sitting with the foot hanging off the edge of the table. The ankle is held in **10° to 20° of plantarflexion**.
What happens?
The examiner stabilizes the distal tibia and applies a **straight anterior translation force** (pulling forward) to the calcaneus and talus.
In Plain English
What Does a Positive Result Mean?
**Excessive anterior translation** of the talus on the tibia, compared to the unaffected side, or a 'soft' (absent) endpoint, indicating an ATFL tear.
Helpful Tip:
A difference in translation of 3mm or more compared to the opposite side is generally considered positive for a tear.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other ankel Tests
External Rotation Stress Test (or Syndesmosis Ligament Test)
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (the 'high ankle sprain' ligaments, including the AITFL and PITFL).
Figure of Eight Method of Measuring Ankle Joint Swelling
To quantitatively measure and track **ankle and foot edema (swelling)** volume over time.
Impingement sign ankle (Anterior Ankle Impingement)
To diagnose **Anterior Ankle Impingement Syndrome** (bony or soft tissue impingement at the front of the joint).
Kleiger's Test (External Rotation Test)
To assess the integrity of the **Distal Tibiofibular Syndesmosis** (high ankle sprain) and the **Deltoid Ligament** (medial ankle).