A Biomechanical Analysis of the Squeeze Test for Sprains of the Syndesmotic Ligaments of the Ankle

Abstract

The “squeeze test” is a clinical test for detecting “stable” syndesmosis injuries. The test is positive when proximal compression of the calf produces pain in the area of the distal tibiofibular and interosseous ligaments. The purpose of this study was to examine what fibular movement, if any, occurs at the level of the ankle mortise when compression is applied proximally. A differential variable reluctance transducer was inserted into the origin and insertion of the anterior tibiofibular ligaments of fresh cadaver human lower limbs which had been prepared to simulate the clinical conditions of the squeeze test. Compression was applied both manually and with a specially designed clamp. Squeezing the calf caused separation of the distal fibula and tibia.