Your older child is active and involved in sports. You might be an anxious by-stander or the pseudo-coach. Somebody twists their ankle, wrist or knee. They are right back up and play resumes, but you worry how to treat that minor injury.
I use the pneumonic device R.I.C.E. for most minor injuries seen in the office. “R” is for rest. The period of rest might be hours or weeks depending on the severity of the injury. If your adolescent requires more than a couple of days of rest, you need to call me at the office. “I” is for ice. Cold is necessary to reduce the swelling. You can use regular ice wrapped in a towel or a chemical coolant available at drug stores. One trick I like for home use is a bag of frozen peas. They mold to the injured area and are available in most homes. “C” is for compress. A compression dressing like an ace wrap will control the swelling and give mild stability for the injured joint. “E” is for elevate. Elevating the foot or knee will reduce the swelling common even with minor injuries and uses gravity to reduce the fluid buildup in the tissue from the injury.
Most injuries can be watched at home and managed without my medical care. If your adolescent can’t bare weight on the injured limb, has intense pain without relief from Tylenol™, has swelling that feels like Jell-O or is mushy, I should examine them. These cautions don’t apply to a preadolescent who doesn’t get sprains easily. Children will fracture a foot or arm before they sprain it. It has to do with ligaments and tendons being stronger than the developing, soft bones. If you think your child has a sprain, it could be a fracture. Call the office if you believe there is a substantial injury.
Children will find unlimited ways to smash their fingers or toes. Just use your imagination and the ways are endless — fingers caught in doors, drawers or windows; fingers smashed with hammers; toes crushed by heavy objects. If the injury involves only the end segment of the finger or toe and does not produce a serious cut, it probably won’t need my attention. Fractures of the end segment of the finger and toes usually don’t require treatment, but when they do, I normally splint the finger or toe. You can do this yourself by taping an adjacent healthy finger or toe to the injured one to stabilize it.
If the injury involves other parts of the finger but your child can move it easily, then treat with an ice pack for swelling and Tylenol™ for pain.
Fingernails are frequently dislodged by these injuries. The entire nail usually doesn’t need to be removed but any portion extending outward can catch on clothing or the surroundings. Clip this portion off. Nail regrowth can take 4 to 6 weeks.