Highway to Heel
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Question 1 of 3
1. Question
What is your initial management?
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Question 2 of 3
2. Question
His cervical spine is clinically cleared. There are no chest, abdominal or pelvic injuries found.
His right ankle is significantly swollen and his toes are dusky purple and cold. There is a palpable dorsalis pedis pulse but a capillary refill of 3-4 seconds. He has extreme pain on palpation over the ankle, foot, heel and calf. He is not tolerating passive movements of the ankle or toes.
What are the three most likely differential diagnoses at this point?
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Question 3 of 3
3. Question
He has been sent for x-ray as shown below. He has fractures to the calcaneal bone and distal third of the fibula. His pain remains intolerable despite 10mg IV morphine.
What is your further management?
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