Which test involves sitting with the lower leg stabilized, externally rotating the heel into plantar flexion to test the deltoid ligament and syndesmotic sprain?

• A. Tinels sign
• B. Morton's test
• C. Kleiger's test
• D. Thompson's test

Answer: (C)

The maneuver described is Kleiger's test. It uses the patient seated with the lower leg stabilized while the examiner externally rotates the heel with the foot in plantarflexion. This position stresses both the deltoid ligament on the medial side and the distal tibiofibular (syndesmotic) ligaments, so reproducing pain or a sense of instability in those areas suggests injury to either structure. Plantarflexion specifically increases the load on the syndesmosis, making this a useful position for detecting syndesmotic sprains in addition to deltoid involvement.

Tinels sign taps over a nerve to reproduce paresthesias, not ligament stability. Morton's test checks for forefoot pain such as Morton's neuroma. Thompson's test assesses Achilles tendon integrity by calf squeeze.