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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. ED orthopedics consultation is required when assistance is needed for reduction and for complicated fractures that may require surgery.

If a type I or V fracture is possible but x rays are negative, treat presumptively for fracture and refer for repeat films in 7-10 days.