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Salter IV fracture

Posted By Sam Dyer, Thursday, August 31, 2017
So working in a walk in ortho urgent care, I see all sorts of general orthopedic conditions. I never knew there were so many nursemaids elbows until I started it. You can imagine the LBP, the knee OA, the ankle sprains, etc. But every so often I get something I don't see very often. This is a Salter IV fracture of the middle phalanx. The kid was playing football and the ball impacted his finger awkwardly. Given the skeletal immaturity, will be treating this conservatively with a splint for a couple of weeks followed by buddy taping and early ROM.

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Russell Smith says...
Posted Tuesday, February 20, 2018
So do you work for an orthopedic surgeon or for an urgent care. Just some thoughts from my 8 1/2 years in pediatric orthopedics.
1. Has this child been referred to either a hand specialist or pediatric orthopedic (assuming you are not part of a group)?
2. Do you typically treat in your urgent care or splint and refer?
3. This has a very high risk for growth arrest, do you have a long term plan for monitoring?
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