Talar Tilt Test: Checking for Ankle Ligament Tears

The Talar Tilt Test is a standard orthopedic maneuver used to assess the stability of the ankle ligaments, particularly the Calcaneofibular Ligament (CFL) on the lateral side and the Deltoid ligament on the medial side.

1. Purpose

The primary purpose of the Talar Tilt Test is to **evaluate** the integrity of the lateral and medial ankle ligaments. Specifically:

• Inversion Stress: Tests the Calcaneofibular Ligament (CFL).
• Eversion Stress: Tests the Deltoid Ligament.

2. How to Perform

1. The patient is positioned in sitting or sidelying with the knee slightly flexed to relax the gastrocnemius.
2. The examiner stabilizes the distal tibia (lower leg) with one hand.
3. The examiner grasps the calcaneus (heel) with the other hand.
4. The ankle is held in neutral (90 degrees).
5. To test the CFL: The examiner adducts (inverts) the calcaneus.
6. To test the Deltoid ligament: The examiner abducts (everts) the calcaneus.

3. Positive & Negative Sign

Positive Sign (Test is POSITIVE):
A positive test (indicating ligament injury) is:

• Excessive inversion or eversion range of motion compared to the uninjured side.
• A "soft" or empty end-feel.
• Reproduction of pain.

Negative Sign (Test is NEGATIVE):
A negative test is a firm end-feel with minimal tilting.