The posterior drawer test is performed with the knee flexed to approximately 80°-90°. For this test, it’s essential for the knee to be relaxed so as to really assess the quantity of increase in motion which will be present. I usually do that by palpating the hamstring tendons to form sure they’re relaxed.
The posterior drawer test is performed by holding the patient´s wrist [20] or forearm [1] with one hand and placing the opposite fork over the patient´s shoulder in order that the thumb is within the front and therefore the fingers within the back. The thumb should be placed over the humeral head while applying a posteriorly directed force. The posterior drawer test is meant to assess the integrity of the posterior capsular structures and a posterior component of the glenoid labrum.
Test
The patient must be examined supine. The examiner stands level with the affected shoulder. Assuming the left shoulder is being tested, he grasps the patient’s proximal forearm with his left hand, flexes the elbow to about 120°, and positions the shoulder into 80-120° of abduction and 20-30° of forwarding flexion. The examiner holds the scapula with his right hand with his index and middle finger on the scapula spine and the thumb lies immediately lateral to the coracoid process so that its ulnar aspect remains in contact with the coracoid whilst performing the test. With his left hand, the examiner slightly rotates the upper arm medially and flexes it to about 90° – during this maneuver, the thumb of the examiner’s right hand subluxes the humeral head posteriorly. This posterior displacement can be appreciated as the thumb slides along the lateral aspect of the coracoid process towards the glenoid, and the humeral head abuts against the ring finger of the examiner’s right hand. This maneuver is pain-free but is often associated with a slight to moderate degree of apprehension.
As in the load and shift and anterior drawer, this can be repeated in different positions of flexion and medial rotation to search out the posterior glenohumeral ligament complex and posterior labral integrity.
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