The Anterior Drawer (ankle) test primarily indicates injury to which structure?

• A. Sprain of the anterior talofibular ligament and associated capsule
• B. ATFL and CFL sprain
• C. Deltoid ligament sprain
• D. Syndesmosis sprain

Answer: (C)

The Anterior Drawer test of the ankle mainly assesses the anterior talofibular ligament. When you stabilize the leg and pull the talus forward under the tibia, you stress the ATFL, so increased anterior translation or a soft end feel indicates ATFL laxity. This ligament is the most commonly injured in lateral ankle sprains, so the test is most specific for ATFL injury (often with some capsule involvement in the same region). The deltoid ligament on the medial side is evaluated with other tests (eversion or Kleiger), and syndesmotic injuries require different maneuvers (external rotation or squeeze tests). The calcaneofibular ligament can be involved in more severe sprains, but the anterior drawer test is best interpreted as ATFL injury.