Deltoid Ligament Sprain

Question on a patient that presents with a Deltoid Ligament Sprain
Deltoid Ligament Sprain

Patient is a 22-year-old collegiate basketball player who landed on another player’s foot when coming down with a rebound. The player felt immediate pain and was taken to the locker room for X-rays. The X-rays were negative for fracture. The patient presents with Grade-2 laxity of the deltoid ligament with a positive medial talar tilt test. The patient has difficulty with weight bearing and is wearing a walking boot. There is pain and tenderness along the medial ankle.

Question: What are two other special tests (besides the medial talar tilt test) that are commonly used to assess a deltoid ligament sprain? 

Potential answers:

A. Posterior Drawer Test & Kleiger Test

B. Posterior Drawer Test & Proprioception Test

C. Anterior Drawer Test & Posterior Drawer Test

D. Anterior Drawer Test & Kleiger Test

Answer with rationale:   A.  Posterior Drawer Test & Kleiger Test. The Posterior Drawer Test assesses ligament instability at the ankle. It is positive if there is excessive instability with a posterior glide of the talus on the tibia.  The Kleiger Test is an external rotation test that checks for rotational abnormalities in the deltoid ligament. A positive test would produce medial joint pain. Both of these tests would be positive with a deltoid ligament sprain. 

For more information see Chapter 206: Deltoid Ligament Sprain in the Color Atlas of Physical Therapy.