Acute pain management
Open fractures require immediate IV antibiotics and urgent surgical washout
Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
Consider risk for compartment syndrome
CAM walker boot can be used as alternative to casting strategies .
Definite fracture
Immobilize in long leg splint (knee flexed to provide rotational control and prevent weight bearing)
Ortho follow up next day for definitive casting. Usually takes 3-4 weeks for healing without further intervention.
Serial radiographs to monitor for developing deformity (ie leg length discrepancy or varus/valgus angular deformity).
Negative x-ray with high suspicion for occult fracture
Immobilize and follow up with ortho for bone scan or repeat x-ray in 1 week
Immobilize in long leg splint (knee flexed to provide rotational control and prevent weight bearing)
Ortho follow up next day for definitive casting. Usually takes 3-4 weeks for healing without further intervention.
Serial radiographs to monitor for developing deformity (ie leg length discrepancy or varus/valgus angular deformity).
Immobilize and follow up with ortho for bone scan or repeat x-ray in 1 week
Toddler's fracture
Hangman's fracture
Tibial spine fracture
Smith's fracture
Tibial tuberosity fracture
Barton's fracture
Maisonneuve fracture
Tillaux fracture