Education regarding shoe wear
- extra wide / large toe box
Insoles
- longitudinal arch support
- pre MT dome for metatarsalgia
- podiatry to attend to callosities
Toe spacers
Analgesia
1. Continued pain and discomfort
2. Difficulties with shoe wear
Prospective multi-centred RCT
- 309 displaced intra-articular fractures
- operative v non operative management
- 2 year follow up
Findings
- used patient orientated functional outcomes
- overall VAS and SF36 not significantly different between 2 groups
Improved Operative Outcome if
- not workers compensation
- women
- < 29
Curves < 20o observation only at 3-6 month intervals depending on growth rate
Never brace curves if patient Risser 4 or 5
1. Risser 0-2 (growth potential)
2. Curve >30o adolescent
3. Curve >25o with progression (5o in six months)