Execution
- 1Position the patient supine or sitting with the foot relaxed.
- 2Stabilize the distal tibia and fibula with one hand.
- 3Grasp the calcaneus and talus with the other hand.
- 4Invert the hindfoot to tilt the talus within the ankle mortise.
- 5Compare laxity, end feel, and pain with the opposite side.
Positive outcome
Excessive inversion tilt, pain, or a soft end feel compared with the other ankle is positive for lateral ligament injury, especially CFL involvement. Testing at neutral versus plantarflexion changes ligament bias. Gross laxity suggests more severe combined lateral ligament injury.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Beynon et al. (2022) | systematic review, evidence variable | NA | NA | NA | NA |
| Docherty & Rybak-Webb (2009) | arthrometer reliability study | NA | NA | NA | NA |
CommentTalar tilt is a classic lateral ankle ligament test, but manual estimation of small angular differences is difficult. It is more helpful when laxity is obvious or when compared with the contralateral side. Use with anterior drawer and delayed re-examination rather than alone.
Low Clinical Value