Pediatric emergency medicine trisk 3491 3491
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over the lateral and dorsal aspects of the foot and by checking ankle eversion and
dorsiflexion.
Management. X-ray is the initial imaging modality of choice for the
identification of the specific fracture or dislocation ( Fig. 111.34 ). The patient
should be placed on bed rest with no weight-bearing. Orthopedics should be
consulted for all hip dislocations and femur fractures.
Hip dislocation . Traumatic hip dislocation in children is uncommon, though can
be recognized in the child presenting with a painful, shortened, externally rotated
limb. Most hip dislocations are in the posterior direction. Spontaneous reduction
at the time of injury also can occur. If this is suspected, x-rays of the hips should
still be obtained with attention directed to the medial clear space of the hips,
which will be wider after trauma than the normal contralateral side ( Fig. 111.35
).
