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Chapter 15
Extremity Injuries
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Extremity Injuries
Injuries to the extremities are common because people are involved in active lifestyles that include sports and wilderness activities.
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Extremity Injury Assessment
• Look for
• Examine the extremities using
• Compare
• Use
• Consider the
• Use
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Types of Extremity Injuries (1 of 2)
• Contusions
• Strains
• Sprains
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Types of Extremity Injuries (2 of 2)
• Tendonitis
• Dislocations
• Fractures
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Care for Extremity Injuries
•
•
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RICE Procedures (1 of 7)
• Acronym
• Recommended
• The first
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RICE Procedures (2 of 7)
• R = • .•
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RICE Procedures (3 of 7)
• I • • • •
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RICE Procedures (4 of 7)
• C •
•
•
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RICE Procedures (5 of 7)
• E •
•
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RICE Procedures (6 of 7) • R =
• I = • .
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RICE Procedures (7 of 7)
• C = •
• E = •
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Shoulder Dislocation
• Occurs • Result of
• Second in
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Recognizing a Shoulder Dislocation (1 of 2)
• Victim holds
• Arm cannot
• Extreme
• Shoulder appears
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Recognizing a Shoulder Dislocation (2 of 2)
• Injury results in.
• History of
• Numbness or paralysis
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Care for a Shoulder Dislocation
• Do not
• Place a
• Apply
• Apply.
• Seek
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Clavicle Fracture
• Common
• Usually result of
• Most occur in the
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Recognizing a Clavicle Fracture (1 of 2)
•
• Fell on
• Direct
• Severe
• Holding injured arm
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Recognizing a Clavicle Fracture (2 of 2)
• No movement
•
•
•
•
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Care for a Clavicle Fracture
• Treat for
• Apply and swathe.
• Apply ice pack: • ___ minutes, __to __times during 24
hours
• Seek _______medical care.
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Contusions
•Caused by
•Often called
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Recognizing Contusions
•
• Pain at
• Feeling of
•
• Black-and-blue discolorations
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Care for Contusions
• Apply an ice pack: •
• Place arm in sling and swathe.• •
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Tendonitis
• _________of the shoulder
• Result of
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Recognizing Tendinitis
• Constant or
• Limited _____of shoulder
• “_______” sound
• _________over the area
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Care for Tendonitis
• Use an ice massage for __ minutes before and after exercise.
• Use a
• Use pain medication.
• Seek medical advice.
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Humeral Fracture
• Shaft of the humerus can be
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Recognizing a Humerus Fracture
• Direct blow
• Twist or fall
• Severe
• Deformity
• Tender if touched
• Inability
• Holds
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Care for a Humerus Fracture
• ______and treat for shock.• Apply an ice pack for
___minutes.• Stabilize the arm.• Seek immediate medical care.
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Elbow Injuries
• Should be considered serious
• Treat with extreme care.
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Recognizing Elbow Fractures and Dislocations
• Immediate
• Severe
• Possible
• Restricted, painful motion
• Numbness
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Care for Elbow Fractures and Dislocations
• Do not
• Treat for
• Splint the
• Apply
• Seek
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Tennis Elbow
• Results from
• Inflammation of the
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Recognizing Tennis Elbow
• Pain increases
• Gradual grip
• Injured
• Very tender on
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Care for Tennis Elbow
• Apply heat • Apply ice pack
• Seek
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Golfer’s Elbow
• Equivalent to
• Pain is on
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Recognizing Golfer’s Elbow
• Pain increases
• Gradual
• Injured elbow
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Care for Golfer’s Elbow
• Apply
• Apply an ice pack for __ minutes after activity.
• Seek medical advice.
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Radial and Ulnar Fractures
• The radius and ulna are the two large bones in the forearm.
• When one bone is broken, the other acts as a splint, and there may be little or no deformity.
• When both are broken, the arm usually appears deformed.
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Recognizing Radius and Ulna Fractures
• Pain in • Deformity • Severe pain • Inability to
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Care for Radial and Ulnar Fractures
• Assess and treat for shock if indicated.
• Apply an ice pack for __ minutes.
• Apply
• Seek medical care.
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Wrist Fracture
• Wrist usually
•
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Recognizing a Wrist Fracture
•
•
•
•
•
•
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Care for a Wrist Fracture
•
•
•
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Hand Injuries—Crushed Hand
• May be fractured by:• •
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Recognizing a Crushed Hand
•
•
•
•
•
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Care for a Crushed Hand
•
•
•
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Finger Injuries
• The __bones that make up each finger are the most commonly broken bones.
• The finger has three joints: • • •
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Finger Fracture
• Finger bones can move when they are broken.
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Recognizing Finger Fractures
•
•
•
•
•
•
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Testing Finger Fractures
• If possible,
• Tap the • Pain
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Care for Finger Fractures
• Do not try
• Gently apply an ice pack.
• Splint the finger.• •
• Seek medical care.
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Finger Dislocation
• Common
• Same causes of fractured fingers
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Recognizing Finger Dislocation
•
•
•
•
•
•
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Care for Finger Dislocation
• Do not try to realign.
• Apply an ice pack for 20 minutes.
• Splint the finger.• •
• Seek medical care.
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Sprained Finger
• Upper joints of the fingers have a ligament on each side of the joint.
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Recognizing a Sprained Finger
• “
•
•
• Pain and swelling
• Unable to make a fist
• Weakness
• Weakness or pain
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Care for a Sprained Finger
• Apply an ice pack for ___ minutes.
• Reevaluate.
• Seek medical care if pain and weakness exist.
• “______” tape the fingers.
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Nail Avulsion
• Injury in which a nail is partly or completely torn loose
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Recognizing a Nail Avulsion
• Nail may be
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Care for a Nail Avulsion
• Secure • Apply antibiotic ointment.• Secure a. • Do not trim away loose nail.• Consult a physician.
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Splinters
• Sharp splinters, usually wooden, can be impaled into the skin or under a fingernail or toenail.
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Recognizing Splinters
• Small puncture wound
• Sliver may be seen.
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Care for Splinters• Use tweezers to remove it. • If splinter is impaled under a nail and
breaks off flesh: •
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Blood Under a Nail
• Blood
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Recognizing Blood Under a Nail
•
•
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Care for Blood Under a Nail
•
•
• .
• .
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Ring Strangulation
•
• Within ___ or ___ hours
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Recognizing Ring Strangulation
• A ring has become tight on a finger.
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Care for Ring Strangulation (1 of 2) •
•
• Spray onto finger.
• Massage finger from tip to hand.
• Smoothly wind.
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Care for Ring Strangulation (2 of 2)
• Lubricate finger well, and then
• Cut the _________part of the ring.
• Inflate an ordinary balloon. •
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Hip Joint Injuries
• Hip joint is a
• Requires great force to dislocate
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Recognizing Hip Dislocation
• Severe pain at injury
• Swelling at injury
• Hip is flexed and knee is bent and rotated inward toward opposite hip.
• Visible injury
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Care for Hip Dislocation
• Assess and treat for shock.
• Stabilize injury.
• Check for ankle pulse.
• Seek medical care.
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Hip Fracture
• •
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Recognizing a Hip Fracture
• Severe pain in groin area
• Inability to lift injured leg
• Leg may appear shortened and be rotated with the toes pointing abnormally.
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Care for a Hip Fracture
• Treat for shock.
• Stabilize injured leg.
• Monitor ankle pulse.
• Seek immediate medical care.
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Femur Fractures
• Femur injuries can occur in any part of the femur.
• Femur fractures often include open wounds.• External bleeding may be severe.
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Recognizing a Femur Fracture
• Severe pain at injury
• Deformity
• Swelling
• Severe pop or snap
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Care for a Femur Fracture
• Assess and treat for shock.
• Cover wound with sterile dressing.
• Stabilize injured leg.
• Monitor ankle pulse.
• Seek immediate medical care.
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Muscle Contusion
• The muscle group on the front of the thigh is the quadriceps group. • Often gets bruised
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Recognizing a Muscle Contusion
• Swelling• Pain and tenderness• Tightness or firmness of site • Visible bruise
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Care for a Muscle Contusion
• Follow the RICE procedures.• •
• Stretch the muscle.
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Muscle Strain
• Occurs when a muscle is overstretched
• A first aider will be unable to determine its degree.
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Recognizing a Muscle Strain
• Pop or pulling sensation while running or jumping
• Tenderness
• Stiffness and pain
• Swelling
• Visible bruise appears days later.
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Care for a Muscle Strain
• Follow the RICE procedures.• Apply an ice pack. • 20 minutes, three to four
times a day for 48 hours
• Stretch the muscle.
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Knee Injuries
•
•
• .
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Recognizing a Knee Fracture
• May look like a dislocation
• Deformity
• Tenderness
• Swelling
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Care for a Knee Fracture• No deformity:
• Feel for pulse in the ankle. • If pulse is felt, splint the leg with the knee straight.
• Significant deformity:• Feel for pulse in the ankle.• If pulse is felt, splint the knee in the position found.
• Seek medical care immediately if pulse is absent.
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Knee Dislocation
• A knee dislocation is a serious injury.
• Deformity will be grotesque.
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Recognizing a Knee Dislocation
• Excruciating pain
• Deformity
• Pulse may be absent in the ankle.
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Care for a Knee Dislocation
• Stabilize the knee in the position found.
• Seek medical care immediately.
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Patella Dislocation
• Must be treated immediately
• Most commonly occurs in teenagers and young adults who are engaged in athletic activities.
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Recognizing a Patella Dislocation• A blow or twisting causes kneecap to
move outside of the knee joint.
• Swelling
• Inability to bend or straighten knee
• Pain
• Deformity
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Care for a Patella Dislocation
• Follow the RICE procedures.
• Do not try to relocate.
• Splint knee in position found.
• Seek medical care.
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Knee Sprain
• Ligament injury
• Can range from mild to complete tearing
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Recognizing a Knee Sprain• Severe pain• Pop or snap at the time of injury• Locking sensation• Inability to walk without limping • Inability to bend or straighten the knee• Swelling• Bruising
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Care for a Knee Sprain
• Follow the RICE procedures.
• Seek medical care.
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Knee Contusion
• Caused by:• A direct blow • Falling on the knee
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Recognizing a Knee Contusion
• Pain
• Swelling
• Tenderness
• Black-and-blue discoloration
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Care for a Knee Contusion
• Follow the RICE procedures.
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Lower Leg InjuriesTibia and Fibula Fractures
• Can occur at any place between the knee joint and the ankle joint
• Deformity may occur when one bone is broken.
• When only one bone is broken, little deformity may be present.
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Recognizing Tibia and Fibula Fractures
• Severe pain
• Swelling
• Deformity
• Tenderness
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Care for Tibia and Fibula Fractures
• Stabilize the leg.
• Apply an ice pack.
• Seek medical care.
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Recognizing Tibia and Fibula Contusion
• Victim received a direct hit directly on shin.
• Tender when touched
• Sharp pain
• Black-and-blue mark
• Difficulty moving ankle up and down
• Numbness or coldness in toes or foot
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Care for a Tibia and Fibula Contusion
• Expose the injury.
• Apply the RICE procedures.• Use an ice pack. • 20 minutes, three to four times daily for
48 hours
• If numbness or tingling exists, seek medical care.
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Muscle Cramp
• Temporary condition
• Usually occurs in the calf and sometimes in the thigh or hamstring
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Recognizing a Muscle Cramp
• During or after intense exercise sessions
• Painful muscle contraction or spasm that disables the victim
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Care for Muscle Cramps
• Gently stretch.
• Apply pressure.
• Apply ice to the muscle.
• Pinch the upper lip hard.
• Drink lightly salted, cool water.
• Drink a commercial sports drink.
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Shin Splints
• Pain in the front of the lower leg or shin
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Recognizing Shin Splints
• Ache subsides after activity stops.
• Ache is a result of an increase in the workout routine.
• Chronic problem that gets worse
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Care for Shin Splints
• Apply an ice pack before activity.
• Apply pressure.
• Apply an ice pack for 20 minutes after activity.
• Curtail activity until the shin is pain free.
• Take anti-inflammatory pain medications.
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Ankle and Foot Injuries
• Frequently injured by twisting• Stretches or tears ligaments
• Most ankle injuries are sprains that involve the outside ligaments.
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Recognizing Foot and Ankle Injuries (1 of 2)
• Two-part test to determine whether an X-ray is needed:• Press along the bones.
• Pain and tenderness may indicate a broken bone.
• Have the victim try to stand on it. • Ability to take four or more steps is most
likely a sprain.• Inability to walk on it may indicate a break.
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Recognizing Foot and Ankle Injuries (2 of 2)
• If injured ankle cannot tolerate hopping on opposite foot, suspect a fracture.
• Swelling• One sided indicates a sprain.• Both sided indicates a fracture.
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Care for Foot and Ankle Injuries
• Take shoes off. • Use RICE procedures.
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Aftercare of an Ankle Injury (1 of 2)
• Use the RICE treatment for 24 to 48 hours.
• Use a contrast bath if swelling persists.
• Begin range-of-motion exercises once initial swelling has decreased.
• Begin gentle exercises.
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Aftercare of an Ankle Injury (2 of 2)
• Within 7 to 14 days, if pain and swelling have stopped, begin to stretch and strengthen the calf and ankle.
• Brace or tape healed ankle.
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
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Toe Injuries
• Include: • Torn-off nails• Hematoma formation under the nails• Dislocations• Fractures
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Recognizing Toe Injuries
• Pain and swelling
• Deformity
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Care for Toe Injuries
• Treat the same as a finger injury.