Knee and Ankle Drawer Tests

Matt Wedel, PhD

Anterior
Cruciate
Ligament

Posterior
Cruciate
Ligament
 Anterior drawer test

Anterior Tests ACL – positive

Cruciate test indicates a tear
Ligament
resists

Anterior movement (of

the leg on the thigh)
=
Positive anterior
drawer sign
->
Posterior
Torn anterior cruciate
Cruciate
ligament
Ligament
is lax
Anterior
Cruciate
Ligament

Posterior
Cruciate
Ligament
 Posterior drawer test

Anterior Tests PCL – positive

Cruciate test indicates a tear
Ligament
is lax

Posterior movement (of

the leg on the thigh)
=
Positive posterior
drawer sign
->
Posterior
Torn posterior cruciate
Cruciate
ligament
Ligament
resists
Posterior Anterior
Talofibular Talofibular
Ligament Ligament
 Anterior drawer test

Tests ATFL – positive

test indicates a tear

Posterior Anterior Anterior movement (of

Talofibular Talofibular the foot on the leg)
Ligament Ligament =
is lax resists Positive anterior
drawer sign
->
Torn anterior talo-
fibular ligament
Posterior Anterior
Talofibular Talofibular
Ligament Ligament
 Posterior drawer test

Tests PTFL – positive

test indicates a tear

Posterior Anterior Posterior movement (of

Talofibular Talofibular the foot on the leg)
Ligament Ligament =
resists is lax Positive posterior
drawer sign
->
Torn posterior talo-
fibular ligament
What about medial ankle ligaments?

In contrast to the smaller, separated

lateral collateral ligaments, the deltoid
ligament (= combined anterior tibiotalar,
tibionavicular, tibiocalcaneal, and
posterior tibiotalar ligaments) is so strong
that it is difficult to tear without also
fracturing one or more bones. So you
don’t usually need a drawer test to know
that something is amiss. That said, the
anterior and posterior tibiotalar ligaments
would most strongly resist anterior and
posterior movement of the foot on the
leg. The anterior tibiotalar ligament resists
anterior movement of the foot, and a tear
would contribute to an anterior drawer
sign, and vice versa for posterior.

Plate 354 from Gray, Henry. 1918. Anatomy of the Human Body.
Philadelphia: Lea & Febiger. www.bartleby.com/107/.