When a child with a musculoskeletal injury on the foot is assessed, what is most indicative of a fracture?
a. Increased swelling after the injury is iced
b. The presence of localized tenderness distal to the site
c. The presence of an elevated temperature for 24 hours
d. The inability of the child to bear weight
D
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A Although edema is often present with a fracture, it would be unusual for swelling
to increase after application of ice, and this would not be most indicative of a
fracture. Swelling after icing does not identify the degree of the injury.
B Localized tenderness along with limited joint mobility may indicate serious
injury, but inability to bear weight on the extremity is a more reliable sign.
Tenderness is not a usual complaint distal to the affected site.
C Elevated temperature is associated with infection, but not a fracture.
D An inability to bear weight on the affected extremity is indicative of a more
serious injury. With a fracture, general manifestations include pain or tenderness
at the site, immobility or decreased range of motion, deformity of the extremity,
edema, and inability to bear weight.
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