Copyright ©The Author(s) 2017.
World J Orthop. Jan 18, 2017; 8(1): 21-29
Published online Jan 18, 2017. doi: 10.5312/wjo.v8.i1.21
Table 8 Examination techniques of performing the foot and ankle special tests[2,3,9,10]
Name of the testPurpose of the testManoeuvre
Silfverskiold testDifferentiate between a tight gastrocnemius and a tight soleus muscleThe leg hangs loosely off the table - knee flexed Dorsiflex the ankle to the maximum Patient should then extend their knee Repeat the ankle dorsiflexion (Figure 10) If there was more ankle dorsiflexion with the knee flexed then there is gastrocnemius tightness
Thompson’s testAchilles’ tendon rupturePatient lies is prone on the bed or kneel on a chair The examiner gently squeeze the gastrocsoleus muscle (calf) If the tendon is intact, then the foot passively plantar flexes when the calf is squeezed
Test for tarsal tunnel syndromeCompressions of the posterior tibial nerve underneath the flexor retinaculum at the tarsal tunnelTap inferior to the inferior to the medial malleolus to produce Tinel’s sign
Test for flat footDifferentiate between flexible vs rigidAsk patient to stand on tiptoes If the medial arch forms and heel going into varus then it is flexible flat foot Beware of rupture tibialis posterior tendon or tarsal coalition
Test for stress fracturesStress fracturesPlace a tuning fork onto the painful area If it increases the pain, then it is positive Other test: One spot tenderness on palpation with finger
Babinski’s responseUpper motor neuron diseaseScratch the lateral border of the sole of the foot A positive response is dorsiflexion of the great toe
Oppenheim’s testUpper motor neuron diseaseRun a knuckle or fingernail up the anterior tibial surface A positive response is dorsiflexion of the great toe
Mulder's testMorton’s neuromaA mass felt or audible Click is elicited by palpating (grasping) the forefoot (web space) with the index finger and thumb of the examiner