Orthopedic Assessment Methods
Summary: This podcast features orthopedic assessment videos which demonstrate various orthopedic assessment techniques. These methods are primarily used as review of the material for students in athletic training and physical therapy.
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- Artist: Scott R. Sailor, EdD ATC
- Copyright: Creative Commons - Attribution-Noncommercial-No Derivs-2.5
Podcasts:
Click to Play The Anterior Drawer Test is used to assess for instability of the ankle. Laxity is typically due to a sprain of the anterior talofibular ligament. To administer the test the examiner stabilizes the lower leg of the patient with one hand while the other hand cups the heel. An anterior force is applied to the heel while attempting to move the talus anteriorly in the ankle mortise. This test is administered bilaterally and results are compared.
Click to Play The heel percussion test (AKA bump or tap test) is used to differentiate a tibial stress fracture from medial tibial stress syndrome. The examiner stabilizes the patient's lower leg on the table and brings the foot into a relaxed neutral position. The examiner then applies a percussive force to the plantar surface of the heel toward the lower leg. A positive result of this exam will be the illicitation of localized pain at the point of the suspected fracture.
Click to Play Pott's Compression (AKA squeeze) test is used to assess for the presence of a fracture of the lower leg. The examiner places the pads his or her hands on either side of the upper portion of the leg, one being located just distal to the head of the fibula and the other being at the same level on the medial border of the tibia. The examiner then pushes his or her hands together to squeeze the tibia and fibula together. If the athlete reports a pain at the distal tibia or distal fibula the exam is considered positive.
Click to Play This test is used to determine if there is instability caused by a sprain of the Deltoid ligament of the ankle. The patient is examined in a seated position with his or her knee flexed over the end of the table and foot relaxed non-weight bearing. The examiner grasps the foot and rotates it laterally in the mortise of the ankle. Increased instability compared bilaterally with or without pain is an indication of a positive test. The examiner may also palpate a talar displacement.
Click to Play The talar tilt test is used to examine the integrity of the calcaneofibular or the deltoid ligament. The patient is seated confortably on the end of an exam table. Possible alternate positions can be sidelying or supine. The examiner grasps the foot and places it in anatomical position while stabilizing the tibia and fibula. To test the calcaneofibular ligament the examiner will adduct and invert the calcaneous into a varus position. The deltoid ligament is examined by abducting and everting the calcaneous into a valgus position. A positive test will result in laxity and/or pain.
Click to Play The Thompson test is used to examine the integrity of the Achilles' tendon. With the patient lying prone on the table with his or her foot extended beyond the end of the table the examiner squeezes the calf. A normal non-injured response to this maneuver is slight plantarflexion of the ankle. Lack of ankle movement can indicate a rupture of the Achilles' tendon.
Click to Play Homan's sign is used to determine the presence of a deep vein thrombophlebitis. The patient lies prone on the table with the knee fully extended. The examiner passively dorsiflexes the patient's ankle while palpating the calf. Pain in the calf and/or pain with palpation is considered a positive test.
