ED Pathway for Evaluation/Treatment of Child with a Suspected Extremity Fractures

Vascular Function of Lower Extremity

Pulse Posterior tibial, dorsalis pedis (present, weak, absent)
Compare to opposite extremity
Perfusion Capillary refill
Color
Temperature

*Contact Orthopedics immediately for weak or absent pulse perfusion


Motor and Sensory Exam for Lower Extremity

NERVE SENSORY
Deep Peroneal Dorsal web space 1st and 2nd toes
Superficial Peroneal Remainder of the dorsum of the foot (near DP pulse)
Sural Lateral foot/ ankle
Saphenous Medial ankle

NERVE MOTOR
Peroneal Ankle dorsiflexion
Great toe extension (Extensor Hallucis Longus)
Tibial Ankle plantarflexion
Toe flexion (Flexor Digitorum Longus)
Great toe flextion (Flexor Hallucis Longus)


Motor Sensory
Toe/ Ankle dorsiflexion Dorsal web space between 1st and 2nd toes
(quick test of deep peroneal nerve)
toe and ankle dorsiflexion photo Dorsal web space between 1st and 2nd toes
Tibial Nerve: Test with plantar flexion foot/toes
thumb IP joint normal hand photo thumb IP joint damaged hand photo
front leg diagram
painted leg back
painted bottom of foot