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Retired NBME 20 Answers

nbme20/Block 1/Question#30 (reveal difficulty score)
A 33-year-old woman comes to the emergency ...
Lunate ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: msk

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 +13  upvote downvote
submitted by โˆ—hungrybox(1277)
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Here's my approach (downvote if wrong):

falling on outstretched arm โ†’ usually scaphoid

BUT

scaphoid problem โ†’ pain in anatomical snuffbox

so then it goes to the next most commonly injured bone when you fall on an outstretched arm, your lunate

(which is right next to the scaphoid)

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spaceboy98  Also, dislocation is most common in lunate, Fracture most common in Scaphoid +6



 +6  upvote downvote
submitted by โˆ—hayayah(1212)
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Capitate and lunate are in the center of the palm. Capitate is not an option, so lunate is the answer.

Dislocation of lunate may cause acute carpal tunnel syndrome.

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yotsubato  Lunate is the only carpal bone that is frequently dislocated. Scaphoid is frequently fractured. Hook of hamate is also frequently fractured. +3
redvelvet  and also point tenderness in the anatomical snuffbox may indicate a scaphoid fracture. +3
chandlerbas  yes lunate is the most common dislunated carpal bone ;) +5
almondbreeze  FA 2019 pg. 439 : dislocation of lunate may cause acute carpal tunnel syndrome +1



 +2  upvote downvote
submitted by โˆ—misterdoctor69(70)
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FOOSH (Fall on outstretched hand):

Most common fracture = scaphoid Most common dislocation = lunate

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 +1  upvote downvote
submitted by โˆ—blue4415(4)
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According to Boards and Beyond ๏ผš lunate attached to radius.

falling in outstretched hand, other bones forced backwards when lunate displaced toward palm/ So in this position ,lunate dislocation is most common

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