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Retired NBME 22 Answers

nbme22/Block 1/Question#17 (reveal difficulty score)
A 27-year-old man is brought to the emergency ...
Eversion ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—seagull(1933)
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https://singaporeosteopathy.com/2015/05/23/ankle-injuries-sprain-strains-and-fractures/

Figure 2. although figure 1 looks shockingly similar

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drbravojose  genius +2
alimd  there is no way to distinguish b/n eversion and inversion based on step1 knowledge +3
skonys  i fucking love these test makers +1
ineedhelpwitmed  of course theres a way to distinguish. use ur head, if the MCL is destroyed with forced eversion of the leg, apply it to the ankle +2



 +5  upvote downvote
submitted by โˆ—dentist(94)
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Pott's Fracture: forced eversion of the footโž deltoid ligt avulses medial malleolus โž fibular fracture higher than tib fx

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impostersyndromel1000  as an aspiring MSK radiologist im really upset I missed this. Thanks for explanation. +



 +2  upvote downvote
submitted by _pusheen_(7)
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How can you tell that the ankle fracture is eversion?

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lnsetick  Because there is avulsion fracture on medial side from deltoid ligament and fibular fracture on oppostie side, this is classic for an eversion. +5
alimd  Its more a CK-type question +2
srmtn  I agree that is not a question for step 1. explained: Imagine the mechanism that gives the fracture. When inversion the perone gets avulsion and the tibial malleolus gets compression which makes it a vertical pattern of fracture. when eversion the medial malleolus gets avulsion (usually transverse fracture) and the peroneal gets compression with an oblique or spiral pattern (like in this case) +2



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submitted by โˆ—tekkenman101(19)
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Good description by amboss https://www.amboss.com/us/knowledge/Ankle_fracture

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submitted by โˆ—abhishek021196(119)
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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.

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submitted by โˆ—flecainide(0)
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Ankle fracture classification

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