Stability Examination

The following tests should be performed in the case of an inversion trauma.

The patient sits on an examination table with the lower legs dangling down and no weight bearing on the feet.
Stabilise the distal lower leg with one hand just above the talocrural joint and place the thumb at the height of the sinus tarsi [Figure 140].
With the other hand, take hold of the calcaneus in the neutral position and apply inversion pressure [Figure 140].
Note:
- Abnormal mobility in the talocrural joint (anterior talotibular ligament) and/or the subtalar joint (cavities on the lateral side, and/or laxity) (interosseal calcaneum ligament, calcaneofibular ligament).
- Muscular defence (by the peroneal muscles).
- Tenderness (location, nature).
During this test compare left and right.
The occurrence of one or more of the previously mentioned phenomena increases the probability of a rupture of the anterior talofibular ligament and/or the interosseal calcaneum ligament and/or the calcaneofibular ligament.

Figure 140

The patient sits on an examination table with the lower legs dangling and no weight bearing on the feet.
Stabilise the distal lower leg with one hand just above the talocrural joint.
Take hold of the calcaneus with the other hand, and in doing this bring the foot into slight plantar flexion.
During this the foot concerned should rest on your forearm. With this hand apply a force in a ventral direction [Figure 141].
Note:
- Abnormal mobility in the talocrural joint (the talus moves ventrally with respect to the tibia) (instability and/or laxity).
- Muscular defence (by the extensors).
- Tenderness (localisation, nature).
During this test compare left and right.
The occurrence of one or more of the previously mentioned phenomena increases the probability of a rupture of the anterior talofibular ligament.

Figure 141