Execution
- 1Position the patient prone.
- 2Ask the patient to actively flex both knees to 90 degrees.
- 3Observe the resting position of both feet and ankles.
- 4Compare plantarflexion angle between the affected and unaffected sides.
- 5Note whether the affected foot falls into relative dorsiflexion.
Positive outcome
The test is positive when the affected foot rests in more dorsiflexion than the unaffected side during prone knee flexion. Loss of the normal plantarflexed resting posture suggests Achilles tendon rupture. The sign should be compared bilaterally.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Maffulli (1998) | prospective clinical study | 88 | NA | NA | NA |
CommentMatles is highly useful as part of the Achilles rupture cluster, especially when calf squeeze is equivocal. Maffulli found it significantly more sensitive than gap palpation and Copeland/O'Brien-type pressure tests. Specificity is less clearly reported in readily accessible summaries, so avoid overquoting exact LR values.
High Clinical Value