School of Podiatric Medicine - Student Research

Document Type

Poster

Publication Date

Fall 2025

Abstract

Purpose: This case report details a staged approach in managing a patient who presented to the ER with a displaced proximal second phalanx fracture, extensive soft tissue damage, and diffuse fracture blistering following a motorcycle crash. This case highlights that soft tissue damage may not always correlate with severe osseous injury.

Methodology: This case is a concurrent chart review of a 40-year-old who sustained a low side motorcycle injury resulting in a minimally displaced avulsion fracture of the medial 2nd toe proximal phalanx base with extensive soft tissue damage, fracture blisters, and lower extremity edema.

Procedures: Radiographic evaluation demonstrated no indication for surgical fixation. Conservative management consisted of lower extremity immobilization and application of a bulky dressing with topical antibiotic coverage. The patient independently performed dressing changes using a thin layer of Neosporin ointment, xeroform, iodine-soaked gauze, and overlying compression via a sleeve. Prophylactic oral cephalexin was prescribed for a 12-day course to reduce the risk of infection.

Results: The patient followed up 28 days post-injury after self-conservative care and offloading, showing significant improvement regarding his extent of soft tissue damage (edema, ecchymosis and fracture blisters). Currently, new radiographs have not been obtained.

Discussions: Soft tissue injuries are more common than fractures in low-side motorcycle crashes due to lower energy transfer compared to high-side or collision injuries. The unique biomechanics and vascular anatomy of the foot mean soft tissue damage does not always reflect fracture severity. In this case, immobilization and dressing care were appropriate. The presence of fracture blisters warranted delayed surgical intervention until re-epithelialization, as supported by literature.

Download

Share

COinS