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Pediatrics Case 3 ED Management

Salter-Harris Type IV Fracture of the proximal middle phalanx

ED Management

All types require reduction if significantly displaced, followed by splinting, non-weightbearing status, and orthopedic referral. Orthopedics consultation in the emergency department is required when assistance is needed for reduction and for complicated fractures that may require surgery.

Unlike Type I and II fractures, Salter-Harris III and IV fractures typically require open reduction and internal fixation (ORIF), making expeditious orthopedic follow-up even more important in this patient population.