Which test assesses lateral ankle ligament laxity by applying varus stress to the ankle with the foot in plantar flexion, neutral, and dorsiflexion?

• A. Squeeze test
• B. Kleiger's test
• C. Homan's sign
• D. Talar tilt test

Answer: (D)

The key idea is assessing how stable the lateral ankle ligament complex is when you push the foot into inversion (varus stress) and do so across different foot positions. This test, known as the talar tilt test, evaluates how lax the lateral ligaments are by applying inversion force with the ankle in plantar flexion, neutral, and dorsiflexion. Placing the foot in plantar flexion tensions the anterior talofibular ligament, so laxity there points to ATFL injury. With the foot in neutral, the calcaneofibular ligament is stressed, so laxity in that position suggests CFL involvement. Testing in dorsiflexion changes the tension pattern again and helps reveal the extent of the lateral ligament injury, potentially involving CFL as well or differentiating combined injuries. By comparing laxity across these positions, you can identify which ligament is compromised.

This is distinct from other tests: for example, the squeeze test targets the distal tibiofibular syndesmosis; Kleiger's test looks at deltoid and syndesmotic injury via external rotation; Homan's sign is for deep vein thrombosis.