Dial Test

 Dial Test

What is Dial Test?

Dial Test (or tibial external rotation test) is used in evaluation of posterolateral instability of the knee. It is used to assess abnormal external tibial rotation to help differentiate between an isolated posterolateral corner injury and combined Posterior Cruciate Ligament (PCL) / posterolateral corner (PLC) injuries.

How it’s Performed?

What does a positive Dial Test mean?

In this case, there are three types of injuries:

  1. An isolated injury of the posterolateral corner (PLC): there are more than 10° of external rotation in the injured knee only at 30° of flexion, but not at 90° of flexion.
  2. Posterior Cruciate Ligament (PCL) Instability: there are more than 10° of external rotation in the injured knee at 90° of flexion, but not at 30° of flexion.
  3. A combined injury (PCL & PLC): there are more than 10° of external rotation in the injured knee at 30° and 90° of flexion.

Related Anatomy

Posterolateral Corner (PLC):

The Posterolateral corner (PLC) consists of superficial and deep layers:

The superficial layer is comprised of the:

  1. The biceps femoris tendon.
  2. The iliotibial band.

The deep layer is comprised of:

  1. The lateral collateral ligament (LCL).
  2. The capsule.
  3. The popliteus tendon.
  4. The arcuate ligament.
  5. The popliteofibular ligament.
  6. The fabellofibular ligament.

Injuries of the posterolateral corner of the knee (posterior cruciate ligament, lateral collateral ligament, posterior joint capsule, and the popliteus tendon) result in a varus thrust gait pattern during stance.

Posterior lateral corner PLC
Posterior lateral corner PLC

Posterior Cruciate Ligament (PCL):

Reference

  1. Clinical Tests for the Musculoskeletal System 3rd Edition.
  2. Dutton’s Orthopaedic Examination, Evaluation, And Intervention 3rd Edition.
  3. Campbel’s Operative Orthopaedics 12th edition Book.
  4. Millers Review of Orthopaedics -7th Edition Book.
  5. Ronald McRae – Clinical Orthopaedic Examination 6th Edition Book
  6. Schweller EW, Ward PJ. Posterolateral Corner Knee Injuries: Review of Anatomy and Clinical Evaluation. J Am Osteopath Assoc. 2015 Dec;115(12):725-31. doi: 10.7556/jaoa.2015.148. PMID: 26618818.

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