Avulsion Fracture ?

cannoli · Dec 7, 2003

Are you in Tricare Prime? If so, you have access to your PCM via telephone 24 hours a day, at least thats the case in this region.

kate930 · Dec 7, 2003

Good idea! We're new to this area and I have no clue who our PCM is. I guess I could call the advice nurse and see if she can find out who our PCM is and see if we can get a call into him/her.

I haven't had to use Prime out in the civilian area yet... I'm used to how things are done on base and often forget how things work.

Thanks!!! :)

robynrn2b · Dec 7, 2003

I would have him checked as soon as possible. Could be nuthing--or something. You would hate to look back and say, "I should of taken him in."

P_RN, ADN, RN · Dec 7, 2003

Numb worries me. Did the ER give you a call back number?

If not perhaps you could call them and ask if he should be rechecked. Did they say which bone was affected?

nowplayingEDRN · Dec 7, 2003

Having worked as a RN in a MTF.....if you call that nurse advice line, they will probably tell you that you need to take him to the ER. (At least that is what they say all the time out here) If he is numb and has no sensation of hot or cold, he definitely needs to be evaluated ASAP. Sounds like something is amiss internally in that ankle. Keep us posted, please. (Sometimes TriCare really bites!)

nowplayingEDRN · Dec 7, 2003

Usually in an avulsion Fx....the very end of the tibia is snapped from the ankle rolling over on its self and they almost always immobilize it with a splint. However, with the numbness and loss of sensation....it sounds more like something is dislocated like a step off of the tib/fib. Definitely get checked immediately.

kate930 · Dec 7, 2003

Thank you all for your suggestions! I ended up calling the advice nurse (still haven't figured out how to use Tricare around here) to get permission to go to the ER and to see what she thought.

Well, we went back... and low and behold... they discovered another break. Apparently, about midcalf. :rolleyes:

I was a little irritated because the doc never even looked at my son's leg, nor were any x-rays done. Only his ankle area was examine.

Well, I guess in their defense, his ankle was twice it's normal size, whereas, at a glance, his leg didn't look swollen at all.

What a night! :eek: He's doing pretty good now. He's enjoying the stay-on-the-couch-all-day-and-play-Nintendo Life.

What would you guys do about the school? Would you mention anything to them? I'm wondering if there would be any kind of report. I'm also concerned that there was no teacher in the gym when the accident happened.

Again, I appreciate everyone's input!!! Thanks! :)

jemb · Dec 8, 2003

Originally posted by kate930
What would you guys do about the school? Would you mention anything to them? I'm wondering if there would be any kind of report. I'm also concerned that there was no teacher in the gym when the accident happened.

I wondered when I read your first post in this thread why two classmates instead of an adult helped him down!

I would definitely let the school know what happened- in writing, with copies to supervisors and the district. It was fortunate that his pants leg held him there after he got caught hanging upside down. Had he fallen on his head, things could have been much worse!

My opinion is that it in not appropriate (as in safe!) to let unsupervised 10 year olds have access to a mock climbing mountain.

Whether the kids were allowed to do this, or simply helped themselves to the area during free time has little relevence, either. Insurance companies refer to something like that as an 'attractive nuisance'. In other words, kids will be attracted to it, and the area needs to be secured when adult supervision is not available. (Same reason that backyard swimming pools have to be fenced.)