robin082006
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A 21-year-old man accidentally kicked a ladder in a swimming pool. The rail of the ladder wedged between his first and second right toes. The patient is able to walk. A lacerated wound, which is approximately 4cm long and 2cm deep, is noted in the first interdigital space. X-ray shows: oblique diaphyseal fracture of the second metatarsal bone with mild angular displacement and angle open laterally. No vessels, tendons, or nerves are damaged. His vitals are stable. What will be the most appropriate initial treatment of this patient?
A. Closure of the wound
B. Dressing of the wound
C. Closure of the wound and plaster cast
D. Dressing of the wound and plaster cast
E. Open reduction and closure of the wound
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| sarika
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D. Dressing of the wound and plaster cast
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| lecheah
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i think it's E
one, it's oblique fracture ( unstable )
two, it's an open wound
so what's the answer pls
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| sarika
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the prob is we cant close an open wound due to risk of infection
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| fox
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But this being a displaced # (although "mild" is holding me back) , dont you think it needs open reduction?
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| CocaCola
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???? really not sure but will go with -
E - open reduction and closure of the wound
I think an angulated bone in the foot could present serious morbidity later...
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| robin082006
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answer is D
Closure of the wound increases the risk of infection, do not choose it.
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| anjushree
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metatarsal diaphyseal fracture unless displaced planta pedis ,doesnot req reduction
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| lecheah
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thanks robin
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