What is the treatment for a fractured great toe in a 9-year-old child with autism?

From the Guidelines

The treatment for a fractured great toe in a 9-year-old child with autism typically involves conservative management with rest, ice, compression, and elevation (RICE). The child should wear a hard-soled, stiff shoe or a walking boot for 3-4 weeks to immobilize the toe and protect it during healing. Over-the-counter pain medications like acetaminophen (10-15 mg/kg every 4-6 hours, not exceeding 5 doses in 24 hours) or ibuprofen (10 mg/kg every 6-8 hours with food) can help manage pain 1. For a child with autism, visual schedules and social stories may help explain the injury and treatment process. Sensory accommodations might be necessary when applying ice or wearing protective footwear. Most pediatric toe fractures heal well without surgery, but follow-up with a pediatric orthopedist is recommended to ensure proper healing, typically at 2-3 weeks after injury 1. If the fracture is displaced or involves the growth plate, more specialized treatment may be needed. The child can gradually return to normal activities as pain subsides, usually within 4-6 weeks, though full healing may take 6-8 weeks.

Some key considerations for the treatment of a fractured great toe in a child with autism include:

• The use of visual aids and social stories to help the child understand the treatment process
• The potential need for sensory accommodations when applying ice or wearing protective footwear
• The importance of follow-up with a pediatric orthopedist to ensure proper healing
• The possibility of more specialized treatment if the fracture is displaced or involves the growth plate
• The gradual return to normal activities as pain subsides, usually within 4-6 weeks.

It is also important to note that children with autism may have unique needs and requirements when it comes to medical treatment, and a personalized approach may be necessary to ensure the best possible outcome 1.

From the Research

Treatment for Fractured Great Toe in a 9-year-old Child with Autism

• The treatment for a fractured great toe in a child involves immobilization and support to allow for proper healing 2, 3.
• For a 9-year-old child with autism, the treatment approach may need to consider the child's specific needs and potential challenges in managing the condition 4.
• A study on great toe fractures in children suggests that displaced fractures of the first toe often require referral for stabilization of the reduction 2.
• Another study recommends treating great toe fractures with a short leg walking boot or cast with toe plate for two to three weeks, followed by a rigid-sole shoe for an additional three to four weeks 3.
• In cases of displaced intra-articular fractures of the great toe in children, operative intervention may be necessary, but it is associated with a high complication rate 5.
• When interacting with autistic patients in orthopaedic surgery, it is essential to develop pragmatic strategies and protocols to promote a successful health-care interaction 4.
• While there is limited research on treating toe-related conditions in children with autism, a study on serial casting and bracing to treat toe walking in a child with autism shows promising results 6.