What is the appropriate management for a 43-year-old male patient with a two-week-old left fifth toe fracture, presenting with numbness, decreased inflammation, and normal capillary refill, currently taking acetaminophen and naproxen (Nonsteroidal Anti-Inflammatory Drug)?

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I strongly recommend continuing the current treatment plan for this 43-year-old male with a left fifth toe fracture, with a focus on monitoring the lack of sensation in the toe, which may indicate nerve compression, as suggested by the study on femoral neuropathy 1. The patient should continue wearing the walking boot and taking acetaminophen and naproxen as prescribed for pain management, as supported by the study on postoperative analgesic efficacies of intravenous acetaminophen and fascia iliaca compartment block in hip fracture surgery 2. The diminished inflammation, reduced bruising, and good capillary refill are positive signs of healing, and the in-house meals for 30 days will support proper nutrition for bone healing, as discussed in the context of fracture pain management 3. Extending the work excuse for two more weeks is appropriate to allow adequate rest and recovery. The patient should be instructed to:

  • Elevate the foot when possible
  • Apply ice if swelling returns
  • Report any worsening symptoms immediately Toe fractures typically heal within 4-6 weeks, but the sensory loss may indicate nerve compression that could require additional evaluation if it persists, as highlighted in the study on nerve conduction studies 4 and peripheral nerve stimulation 5. A follow-up appointment should be scheduled in 2 weeks to reassess healing progress and sensory function, considering the potential for prolonged and incomplete recovery in cases of nerve compression 1.

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