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Positive anterior drawer test
6%
257/4025
Increased opening to valgus stress at 30 degrees of knee flexion
5%
197/4025
Positive apprehension sign with lateral patellar translation
1%
31/4025
A 10 degree increased external tibial rotation at 30 degrees of knee flexion
74%
2971/4025
A 10 degree increased external tibial rotation at 90 degrees of knee flexion
14%
544/4025
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A positive "Dial Test" at 30 degrees of knee flexion would be expected in this patient with a posterolateral corner (PLC) injury. The test is positive when there is greater than a 10-15 degree difference compared to the uninjured side. A positive dial test at 30 degrees alone indicates an isolated PLC injury whereas a positive dial test at 30 and 90 degrees indicates a combined PLC and PCL injury. A PLC injury should be suspected based on the given exam findings of a positive reverse pivot shift and a negative posterior drawer. This indicates an injury to the PLC but not the posterior cruciate ligament (PCL). LaPrade et al prospectively evaluated patients with posterolateral injury to the knee and found that the reverse pivot shift test was significantly associated with injury to the LCL, popliteal components, and mid-third lateral capsular ligament. They also noted a significant correlation between injury of the lateral collateral ligament with an increase in external tibial rotation at 30 degrees of knee flexion (Dial Test). Gollehon et al biomechanically demonstrated a 20 degree increase in external rotation with the knee at 30 degrees of flexion after sectioning the lateral collateral ligament. The video demonstrates how to perform the dial test.
3.1
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