Pediatric Limp Treatment & Management

Updated: Sep 26, 2016
  • Author: Brian Wai Lin, MD; Chief Editor: Kirsten A Bechtel, MD  more...
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Treatment

Prehospital Care

Splinting and transportation make up the majority of services that prehospital personnel render to a limping patient.

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Emergency Department Care

See the list below:

  • Emergency care of the limping patient is broken into 4 components:

    • Relief of acute pain

    • Identification of the cause

    • Initiation of therapy for the source of the limping

    • Referral to the appropriate health care professional for follow-up care

  • Reduction of dislocations and displaced fractures reduces discomfort and may restore perfusion in cases of vascular compromise.

  • In cases of suspected osteomyelitis, diskitis, or septic joint, intravenous antibiotics should be initiated as soon as diagnosis is confirmed.

  • Acetaminophen or ibuprofen usually is adequate for pain relief, although opiates or local or regional anesthesia may be required for more painful or extensive conditions.

  • For fractures, sprains, and acute traumatic injuries, immobilization with home care instructions to rest, ice, and elevate the injured area may suffice to provide pain relief.

  • Whenever crutches are dispensed or prescribed, the provider has a duty to train the patient in the proper application, including walking forwards and backwards, plus ascending and descending a few steps. Document training in a chart note.

  • Various fractures and sprains may require splints; prefabricated knee immobilizers and short leg walker boots may be useful in weight-bearing injuries.

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Consultations

In most cases, the diagnosis is clear and no further consultation is necessary. Specific conditions may require consultation from the following specialists:

  • Orthopedic surgeon

  • Infectious diseases specialist

  • Neurologist or rheumatologist

  • Neurosurgeon

  • Child protective services: Any child with an unexplained fracture or injury should be referred for evaluation by Child Protective Services.

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