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Anterior Drawer Test

Designed to detect and grade laxity or insufficiency of the anterior capsular mechanism. (Analogous to the anterior drawer test of the knee). This test was proposed as useful in patients with a painful shoulder where the apprehension test is difficult to interpret. The significant difference between this and the load and shift is the absence of a force 'loading' the humeral head into the centre of the glenoid at the start of the test.

Test

Ideally this test should be performed with the patient in supine as sitting and standing positions have been shown to be unreliable with respect to reproducibility.

The examiner stands facing the affected shoulder e.g. left. They fix the patient's left hand in their right axilla by adducting their humerus.
The affected shoulder is held at 80-120° of abduction, 0-20° of forward Flexion and 0-30° of external rotation. The examiner holds the patients scapula spine forward with his index and middle fingers; the thumb exerts counter pressure on the coracoid. The scapula is fixed. The examiner uses his right hand to grasp the patient's relaxed upper arm and draws it anteriorly with a force comparable to that used in a Lachmann's test. (NB it is possible to repeat the anterior drawer in different positions of abduction and external rotation as described in the load and shift test to test the individual components of the GHL complex.)

Positive

The relative movement between the fixed scapula and the moveable humerus can easily be appreciated and graded. Occasionally the examiner may reproduce an audible click on forward movement of the humeral head due to labral pathology and this is usually associated with apprehension.

Research

No available data

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