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Posterior Drawer Test

Jo Gibson, 2005

The posterior drawer test is designed to assess the integrity of the posterior capsular structures and posterior component of the glenoid labrum.

Test

The patient must be examined in 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, tlexes the elbow to about 120°, and positions the shoulder into 80-120° of abduction and 20-30° of forward tlexion. The examiner holds the scapula with his right hand with his index and middle fmger on the scapula spine and 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 manoeuvre the thumb of the examiner's right hand subluxes the humeral head posterorly. 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 manoeuvre 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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