Test Results
Radiograph: Talus is superimposed and the metatarsal is ladder-like.Treatment
Splint the foot in the realigned position in the adduction position and
then cast the foot for 2 weeks.
Remove the cast and realign in the heel inversion position and then cast
the foot for 2 weeks.
Remove the cast and realign in the flexion of the ankle position and then
cast the foot for 2 weeks.
Apply an ongoing night brace once the cast is removed.
If casting does not permanently realign the foot, corrective surgery is
performed.
Special shoes containing adjustable bars are worn to realign the foot
as a noncasting and nonsurgical intervention.Nursing Interventions
If the foot is in a cast:- Elevate the affected foot on pillows.
- Assess for ischemia: Pain, pallor, pulselessness, paresthesia, paral-
ysis every 2 hours. - Teach parents how to assess for ischemia and how to exercise the
affected foot at home.
Explain to parents the importance of wearing corrective shoes.
Conclusion
The musculoskeletal system provides the framework, protection, and move-
ment for the body through the interconnectivity of bones, muscles, tendons,
ligaments, and fascia. It is also the repository for calcium and phosphorus and
the site where red blood cells are produced.
Soft tissue injuries are the most common musculoskeletal system disorder
because children are exposed to activities that might result in sprains, strains,
and contusions. These activities can also lead to fractures. Fractures can also
be caused by osteogenesis imperfecta where fractures occur for no obvious
reason.
Osteogenesis imperfecta is one of a number of disorders that affect the mus-
culoskeletal system. Some disorders are congenital, such as clubfoot or hip
dysplasia, where there is abnormal development of the hip and torticollis
where the sternocleidomastoid muscle is damaged from intrauterine malposi-
tion of the fetus in or from birth trauma. Ewing sarcoma is cancer of the bone
that is related to chromosomal abnormalities.8(^296) Pediatric Nursing Demystified