From the Research
The treatment for a dislocated 5th toe in a 10-year-old typically involves closed reduction, which means manually realigning the toe without surgery. This approach is based on the most recent and highest quality evidence available, which prioritizes minimizing morbidity, mortality, and optimizing quality of life. The initial step involves evaluating the child with an X-ray to confirm the dislocation and rule out any fractures, as noted in various studies 1, 2, 3, 4, 5. For the reduction procedure, the healthcare provider will administer appropriate pain medication, such as acetaminophen 10-15 mg/kg or ibuprofen 5-10 mg/kg, and may use a digital nerve block with 1% lidocaine (without epinephrine) for local anesthesia, as suggested by recent reviews on analgesic techniques for orthopedic injuries 5. Key considerations include:
- The use of buddy taping to the adjacent 4th toe for immobilization, which has been shown to be effective in managing finger fractures in children 3.
- The importance of wearing comfortable, wide-toed shoes and avoiding sports activities during the healing period.
- Applying ice and elevating the affected area to reduce swelling, as part of standard care for such injuries.
- Follow-up within 1-2 weeks to ensure proper healing and address any complications early, aligning with general principles of managing orthopedic injuries in children.
Given the age of the patient and the nature of the injury, conservative management is preferred over surgical intervention, unless complications or specific conditions necessitate otherwise, as indicated by case reports and studies on similar injuries 1, 4. The choice of treatment should always prioritize the well-being and safety of the child, considering the potential for growth and healing in pediatric patients.