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The Dial test is used to detect the presence of posterior cruciate ligament insufficiency or posterolateral rotary instability or both. This test is also called the tibial external rotation test and the tibial lateral rotation test.
With the patient in the prone position, flex the knees to 30 degrees, externally rotate the legs, and observe for the extent of external rotation by comparing the two limbs. Now flex the knees to 90 degrees, repeat the external rotation and observe for the extent of external rotation by comparing the two limbs.
If there is an increase in external rotation at 30 degrees of flexion and not at 90, damage to the structures of the posterolateral corner of the knee is implicated.
If there is an increase in external rotation at 90 degrees of flexion and not at 30, the posterior cruciate ligament is suspect.
If external rotation is greater in both 30 and 90 degrees of knee flexion then both the posterolateral corner and the posterior cruciate ligament are implicated.
The posterolateral corner structures include the following:
• Arcuate-popliteus complex
• Lateral collateral ligament
• Biceps femoris tendon
• Posterolateral capsule
• Iliotibial band
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