Board Rounds | Medical School Headquarters | Prep For Usmle And Comlex

Session 13 We have a great musculoskeletal question for today. As always, we’re joined by Dr. Andrea Paul from Board Vitals. [01:30] Question A 27-year-old male is undergoing evaluation for left foot weakness. On his exam, he’s unable to curl his toes. He has one of five strength with plantar foot flexion and five out of five with dorsiflexion. His foot is everted at rest and he has decreased sensation on the sole of his foot. What was the most likely mechanism of his injury? (A) Fibular neck fracture (B) Hip dislocation (C) L3 disc dislocation (D) Knee trauma (E) Pelvic fracture [03:45] Thought Process If you have a fibular neck fracture, this will injure your perennial nerve where you will have lots of dorsiflexion and the sensation on the dorsum of the foot. So choice A is out L3 is too high up as well. This involves the sciatic nerve. The patient would have felt a neuropathic pain down the back of the leg. Hip dislocation is unlikely because the patient is a 27-year-old. This is pretty uncommon.