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Synopsis of Pediatric Emergency Medicine. To view current news articles on this topic check Google News. Information prescriptions for patients can be found at Pediatric Common Questions, Quick Answers for these topics: Fractures and Dislocations and Casts and Splints. To view pediatric review articles on this topic from the past year check PubMed. Radiology / Nuclear Medicine / Radiation Oncology How long should ice be applied to a musculoskeletal soft tissue injury? What are the indications for an orthopaedics consultation for a fracture?ģ. Computed tomography can be used for surgical planning.ġ. Generally plain radiographic examination is all that is needed to diagnose the fracture. Overall, only 30% of Salter-Harris fractures cause growth disturbance and 2% have significant functional problems. M = Metaphyseal involvement, E = Epiphyseal involvement, ME = Metaphyseal and Epiphyseal involvement.
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For example, intrarticular fractures of the proximal great toe may need surgical pinning and a 5th metatarsal fracture (Jones Fracture) has a high rate of non union.ĭrs. Sometimes a bulky splint can also be applied.įractures of the great toe and the metatarsals can have higher risks of complications. For toe fractures that are non-displaced or minimally angulated, they can be adequately treated by buddy-taping the toe, and placement in a a hard-soled shoe using crutches. Toe and metatarsal fractures are common in children.
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The patient was to follow-up in approximately 1 week.įigure 23 – AP (left) and lateral (right) radiographs demonstrate a subtle Salter-Harris Type II fracture of the distal phalanx of the first toe. She was also instructed to rest, ice, and elevate her foot and use ibuprofen for pain control. She obtained some immediate relief with these measures. The patient was treated by ‘buddy-taping’ the great toe to the second toe as a splint, and placed into a cast boot to aid support. The radiologic evaluation confirmed the diagnosis of a Salter-Harris II fracture of the distal phalynx of the great toe. She has significant swelling and ecchymosis of the great toe, with point tenderness at the distal phalyngeal joint. The pertinent physical exam reveals a pre-teen in no acute distress. She has iced it several times, but it continues to swell, and has become ecchymotic and she is having some minor problems walking. Last evening she stubbed it on the floor as she was raising her leg for a kick in a martial arts class. A 12-year-old female came to clinic because of pain in her distal great toe.