Fibular Translation Test | Syndesmosis Injury | Ankle Assessment

The syndesmosis is the interosseous membrane that connects the tibia to the fibula. A syndesmosis rupture can result from both inversion trauma and, more importantly, from trauma to the ankle joint in external rotation and dorsiflexion. According to the guideline on ankle injuries of the Dutch Association of Physical Therapists, KNGF, the incidence of syndesmosis injury among all ankle injuries is approximately 1%.

The Fibular Translation Test of the ankle is a common orthopedic test to assess for syndesmosis injuries at the ankle after inversion trauma.
According to Beumer et al. (2011) the fibular translation test has a sensitivity of 75% and a specificity of 88% in the diagnosis of syndesmosis injuries.

To perform this test have your patient in side-lying position and stand on the side of your patient’s heel.

Then fixate the tibia with one hand and perform the translations of the fibula with your other hand anteriorly and posteriorly.

This test is positive for syndesmosis injury if pain occurs during the translations or if the movement is greater on the affected side compared with the unaffected side.

Other common orthopedic tests for syndesmosis injuries are:

• Dorsiflexion External Rotation Stress Test / Kleiger’s Test
• Syndesmosis Ligament Tenderness
• Cotton Test
• Syndesmosis Squeeze Test
• Syndesmosis Signs & Symptoms
• Heel Thump Test
• Crossed Leg Test

Beumer, A., Swierstra, B. A., & Mulder, P. G. (2002). Clinical diagnosis of syndesmotic ankle instability: evaluation of stress tests behind the curtains. Acta Orthopaedica Scandinavica, 73(6), 667-669.ISO 690