Radiological assessment of a modified anterior drawer test of the ankle

Chronic ankle instability is a common complication of ankle sprain. The clinical assessment of ankle instability is usually incomplete and difficult to interpret. Recently, more attention has been paid to the value of the anterior drawer test of the ankle. We assessed the accuracy of a modification of the anterior drawer test, comparing it with radiological stress view of the ankle in 25 patients with recurrent ankle sprain. The radiological examinations were performed by a TELOS instrument and included lateral and anteroposterior stress views. We found that the modified anterior drawer test correlated with the posterior opening of the tibiotalar joint and with the lateral tilt of the talus. We conclude that a slightly positive modified anterior drawer test may indicate injury to the anterior talofibular ligament. A significant movement of the ankle elicited by the modified anterior drawer test may indicate combined injury to anterior talofibular and calcaneofibular ligaments.