A positive anterior drawer test is most likely in which injury pattern?

A positive anterior drawer test is most likely in which injury pattern?

• A. Grade I lateral ankle sprain.
• B. Isolated deltoid injury.
• C. Grade II lateral ankle sprain with partial ATFL tearing.
• D. Syndesmosis sprain.

Answer: (C)

The test mainly checks the stability of the ankle’s front ligaments, especially the anterior talofibular ligament (ATFL). When the ATFL is torn or notably lax, the talus can move forward under the tibia during the test, giving a positive result. In inversion ankle sprains, the ATFL is the first structure affected, and a partial tear (grade II) produces enough laxity to produce noticeable anterior translation of the talus. That makes a positive anterior drawer test most likely in a grade II lateral ankle sprain with partial ATFL tearing. In contrast, an isolated deltoid (medial) injury affects the opposite side and isn’t expected to yield a positive anterior drawer, and a syndesmosis sprain involves high ankle ligaments with different tests and instability patterns. A mild grade I sprain may show only minimal laxity, often not enough to be positive.

The test mainly checks the stability of the ankle’s front ligaments, especially the anterior talofibular ligament (ATFL). When the ATFL is torn or notably lax, the talus can move forward under the tibia during the test, giving a positive result. In inversion ankle sprains, the ATFL is the first structure affected, and a partial tear (grade II) produces enough laxity to produce noticeable anterior translation of the talus. That makes a positive anterior drawer test most likely in a grade II lateral ankle sprain with partial ATFL tearing. In contrast, an isolated deltoid (medial) injury affects the opposite side and isn’t expected to yield a positive anterior drawer, and a syndesmosis sprain involves high ankle ligaments with different tests and instability patterns. A mild grade I sprain may show only minimal laxity, often not enough to be positive.