What is the role of external rotation test in the evaluation of ankle sprains?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

The external rotation test can demonstrate the integrity of the syndesmotic ligaments. The patient sits with the knee flexed to 90°. The foot is gently grasped and rotated laterally with the ankle locked in neutral. A positive test result occurs when the patient has pain over the syndesmosis. The external rotation test has a sensitivity of 20% and a specificity of 84.8%. [5]

A variation on the external rotation test is the Kleiger test. This test can demonstrate the integrity of the deltoid ligament. The patient sits with the knee flexed to 90°. The foot must be relaxed and not bearing weight. The foot is gently grasped and rotated laterally. A positive test result occurs when the patient has pain medially and laterally. The talus may displace from the medial malleolus, indicating a tear of the deltoid ligament.


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