Orthopedic Exam / Special Tests:
The term “high ankle sprain” refers to an isolated injury to the tibiofibular syndesmosis. Syndesmotic sprains occur in about 10-20% of all ankle sprains. The most common mechanism of injury includes excessive dorsiflexion and external rotation of the foot often while skiing, playing football, soccer, or other sports played on turf. The stability of the syndesmosis in dependent on the surrounding bones and ligaments, in particular the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL), interroseous ligament, and the inferior transverse ligament. Applying on compression force in this region following injury will often elicit a painful response.
Special Test: Squeeze Test (leg) aka Compression Test (leg)
- To help identify tibiofibular syndesmotic injuries.
Video Demo Instructions, Procedure, Positive Test:
Squeeze Test aka Compression Test Video Demo – Seated and Supine (Procedure below)
Orthopedic Exam/ Special Test: Squeeze Test of the Leg PROCEDURE:
- the patient lies supine.
- the examiner grasps the lower leg at midcalf and squeezes the tibia and fibula together.
- the examiner performs a compress and release motion.
Orthopedic Exam/ Special Test: Squeeze Test of the Leg POSITIVE TEST:
- A positive test is considered if the patient experiences pain in the area of the syndesmosis.
- Pain in the lower leg may indicate a syndesmosis injury, provided that fracture, contusion, and compartment syndrome have been ruled out
Diagnostic Accuracy: Kappa .75.