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NBME 22 Answers

nbme22/Block 1/Question#17

A 27-year-old man is brought to the emergency ...


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drbravojose  genius +  

 +1  upvote downvote
submitted by dentist(17),

Pott's Fracture: forced eversion of the foot➝ deltoid ligt avulses medial malleolus ➝ fibular fracture higher than tib fx

How can you tell that the ankle fracture is eversion?

lnsetick  Because there is avulsion fracture on medial side from deltoid ligament and fibular fracture on oppostie side, this is classic for an eversion. +2  

A better way to visualize this is the two hands of a clock, with one hand facing 12 and the other facing 6. The vertical line they form represents the fibula of the person's right leg. The lateral force approaches from 3 o'clock, sending the lower hand snapping outwards to point at 5 o'clock.

Pott's fracture, also known as Pott's syndrome I and Dupuytren fracture, is an archaic term loosely applied to a variety of bimalleolar ankle fractures.[1] The injury is caused by a combined abduction external rotation from an eversion force. This action strains the sturdy medial (deltoid) ligament of the ankle, often tearing off the medial malleolus due to its strong attachment. The talus then moves laterally, shearing off the lateral malleolus or, more commonly, breaking the fibula superior to the tibiofibular syndesmosis.

 -2  upvote downvote
submitted by pitaziki(-2),

Why is the answer fibularis brevis and not fibularis tertius? How do you distinguish between the two from this vignette?

gainsgutsglory  tertius is an anterior muscle and overlays the dorsum of foot as it fans out to the toes. Does not relate to the lateral malleolus. +  
adong  wrong question to post on agree with above +