Anterior Drawer Test Of The Shoulder: Difference between revisions
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'''Step1.''' Patient in supine position. | '''Step1.''' Patient in supine position. | ||
'''Step2.''' Relax the affected shoulder by holding | '''Step2.''' Relax the affected shoulder by holding patients arm ( or placing hand on axilla) with therapist one hand. | ||
'''Step3.''' Abduct the patient shoulder between 80 and 120 | '''Step3.''' Abduct the patient shoulder between the 80 and 120 degree, Forward flexed up to 20 degree, laterally rotated up to 30 degree. | ||
'''Step4.''' Stabilize the patient scapula with the therapist opposite hand by pushing the spine of the scapula with | '''Step4.''' Stabilize the patient scapula with the therapist opposite hand by pushing the spine of the scapula with index and middle finer. Applying counterpressure on patients coracoid process with the therapist thump. | ||
'''Step5.''' Draws the humerus forward (anteriorly) using the hand that is holding | '''Step5.''' Draws the humerus forward (anteriorly) using the hand that is holding patients arm (or placing hand on axilla). | ||
'''Step6.''' Positive test indicates the anterior instability decided by the amount of anterior translation which is accessible comparing with the normal side.<ref name=":1" /> | '''Step6.''' Positive test indicates the anterior instability decided by the amount of anterior translation which is accessible comparing with the normal side.<ref name=":1" /> | ||
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|- | |- | ||
|grade 1 | |grade 1 | ||
|Humeral head reaches | |Humeral head reaches glenoid rim | ||
|- | |- | ||
|grade 2 | |grade 2 | ||
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Negative likelihood ratio (-LR) = 0.57<ref name=":0">Farber AJ, Castillo R, Clough M, Bahk M, McFarland EG. Clinical assessment of three common tests for traumatic anterior shoulder instability. ''J Bone Joint Surg Am''. 2006;88(7):1467-1474. doi:10.2106/JBJS.E.00594</ref> | Negative likelihood ratio (-LR) = 0.57<ref name=":0">Farber AJ, Castillo R, Clough M, Bahk M, McFarland EG. Clinical assessment of three common tests for traumatic anterior shoulder instability. ''J Bone Joint Surg Am''. 2006;88(7):1467-1474. doi:10.2106/JBJS.E.00594</ref> | ||
The anterior drawer test (when pain does not prevent it from being performed) | The anterior drawer test (when pain does not prevent it from being performed) is helpful for diagnosing traumatic anterior instability.<ref name=":0" /> | ||
Revision as of 12:03, 21 October 2021
Purpose[edit | edit source]
Anterior Drawer Test of the shoulder is used to examine the Anterior shoulder instability. It can also be used on aching shoulders where the apprehension test is difficult to interpret, and it has allowed us to reliably diagnose anterior subluxations even in patients who may have a negative apprehension test. [1]
Technique[edit | edit source]
Step1. Patient in supine position.
Step2. Relax the affected shoulder by holding patients arm ( or placing hand on axilla) with therapist one hand.
Step3. Abduct the patient shoulder between the 80 and 120 degree, Forward flexed up to 20 degree, laterally rotated up to 30 degree.
Step4. Stabilize the patient scapula with the therapist opposite hand by pushing the spine of the scapula with index and middle finer. Applying counterpressure on patients coracoid process with the therapist thump.
Step5. Draws the humerus forward (anteriorly) using the hand that is holding patients arm (or placing hand on axilla).
Step6. Positive test indicates the anterior instability decided by the amount of anterior translation which is accessible comparing with the normal side.[1]
| Grade | Diagnosis |
|---|---|
| grade 0 | Minimal displacement |
| grade 1 | Humeral head reaches glenoid rim |
| grade 2 | Humeral head can be dislocated but spontaneously resolved |
| grade 3 | Humeral head does not spontaneously reduce |
The click may indicate a labral tear or slippage of the humeral head over the glenoid rim.[3]
Evidence[edit | edit source]
Sensitivity = 0.53
Specificity = 0.85
Positive likelihood ratio (+LR) = 3.6
Negative likelihood ratio (-LR) = 0.57[5]
The anterior drawer test (when pain does not prevent it from being performed) is helpful for diagnosing traumatic anterior instability.[5]
References[edit | edit source]
- David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
- ↑ 1.0 1.1 Gerber, Christian & Ganz, R. (1984). Clinical assessment of instability of the shoulder. With special reference to anterior and posterior drawer tests. The Journal of bone and joint surgery. British volume. 66. 551-6. 10.1302/0301-620X.66B4.6746691.
- ↑ Lizzio VA, Meta F, Fidai M, Makhni EC. Clinical Evaluation and Physical Exam Findings in Patients with Anterior Shoulder Instability. Curr Rev Musculoskelet Med. 2017;10(4):434-441. doi:10.1007/s12178-017-9434-3
- ↑ David J. Magee. Orthopedic Physical Assessment. 6th edition. Elsevier. 2014.
- ↑ Shoulder - Anterior Drawer Test. Physiotherapy University College Copenhagen. Available from: https://youtu.be/G8s_7Q5zfTM%7C300
- ↑ 5.0 5.1 Farber AJ, Castillo R, Clough M, Bahk M, McFarland EG. Clinical assessment of three common tests for traumatic anterior shoulder instability. J Bone Joint Surg Am. 2006;88(7):1467-1474. doi:10.2106/JBJS.E.00594
