Ankle & Foot
Syndesmosis (High Ankle Sprain)
Evidence: suggestive
Fibular Translation Test Special Test
Orthopedic Physical Examination & Clinical Assessment Guide
What is it used for?
- Diagnosing Syndesmosis Injury (High Ankle Sprain).
How to Perform
- Position: Patient lies in a side-lying position.
- Stabilization: The examiner stabilizes the tibia with one hand.
- Action: Grasp the distal fibula (lateral malleolus) with the other hand and attempt to translate it anteriorly and posteriorly relative to the tibia.
Interpretation of Results
- Positive Test: Pain or excessive movement compared to the uninjured side.
Diagnostic Accuracy
- Sensitivity: 75-77%
- Specificity: 88%
Clinical Context & Limitations
The Fibular Translation Test should be considered as one component of a comprehensive musculoskeletal assessment. No single special test has perfect diagnostic accuracy; thus, clinical decision-making should integrate test results with patient-reported symptoms, mechanism of injury, functional impairment, and relevant imaging.
Clinicians should be aware of potential false-positive results in patients with pain sensitisation, muscle guarding, or poor relaxation. For the Ankle & Foot region, combining the Fibular Translation Test with complementary examination tests significantly improves overall diagnostic confidence.
References
- Magee, D. J. (2021). Orthopedic Physical Assessment (7th ed.). Elsevier.
