A 17-year-old boy returns to the emergency department 18 hours after a below-knee plaster cast was applied for…

Question

A 17-year-old boy returns to the emergency department 18 hours after a below-knee plaster cast was applied for an undisplaced fracture of the distal tibia. He has been taking oxycodone but says the pain has climbed steadily since midnight and is now worse than at the time of the injury. The toes are swollen and warm, and passive extension of the toes reproduces severe pain in the calf. Dorsalis pedis and posterior tibial pulses are palpable and sensation is intact. Which one of the following sho…

Accepted Answer

Split the cast down to skin

Answer

Elevate the limb on two pillows

Answer

Give intravenous morphine 5 mg

Answer

Measure the compartment pressures

Answer

Urgent orthopaedic registrar review

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