Which of the following test is used to test anterior instability of shoulder?
Correct Answer: Apprehension Test (crank test)
Description: Pull-push, jerk, and posterior drawer test are used for testing posterior instability of shoulder. Tests for anterior shoulder instability: Anterior shoulder drawer test: with the patient supine, the scapula is stabilized with one hand while the upper arm is held firmly with the other so as to manipulate the head of the humerus forward and backward (like a driver). Apprehension test: this is a provocative test in which the examiner cautiously lifts the arm into abduction, external rotation and then extension, at the crucial moment the patient senses that the humeral head is about to slip out anteriorly and his body toutens in apprehension. Relocation test: this test involves placing the shoulder in the position of apprehension and applying a posteriorly directed force on the humeral head. The result is considered positive if this relieves the patient's apprehension. Fulcrum test: with the patient supine. The clinician takes the shoulder into 90 degree abduction and adds lateral rotation and extension. The test indicate anterior instability if the patient becomes apprehensive. Ref: Neuromusculoskeletal examination and assessment by Nicola J. Petty, Ann P. Moore 2/e, p 195; Ohopedic Physical assessment by david J. Magee 5/e, p 288
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