![]() What radiological investigations should be ordered? Any nail avulsion or displacement out of eponychial fold may indicate a Seymour fracture (see below)ĥ. It is also important to check for significant nailbed injury. It is important to check for angulation/mal-alignment and for rotational deformity (the position of the nail plate will give a guide to this and compare with toes on the other foot) Joint hyperextension or hyperflexion, which can lead to spiral or avulsion fracturesįractured toes usually present with localised bruising and swelling.Crush injury caused by a heavy object falling on the foot or motor vehicle tyre running over foot. ![]() Abduction injury, often involving the 5th digit.Phalangeal fractures are the most common foot fracture in children. How common are they and how do they occur? Growth Plate involvement (Salter-Harris Classification)ģ.Open or closed (includes nail bed injuries).Location of fracture: which toe and which phalanx is affected.Phalanx fractures are classified by the following: Orthopaedic team management is necessary in the case of toe fractures with associated open nailbed injury (Seymour fractures) 2. The big (1st) toe has an important role in toe-off phase of gait suspected fractures should be formally diagnosed with xray with any fractures followed up in with the orthopaedics team.Ĭorrection of any clinically evident angulation is a key part of Emergency Department Management. Suspected fractures of the smaller toes (2nd-5th) with no clinical deformity may not require X-ray, as it would be unlikely to change management.
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