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Toe injuries are common in the emergency department and most of them are treated conservatively. In some circumstances, these injuries can present as a physeal fracture with concomitant soft-tissue injury affecting the nail bed and resulting in a hidden open fracture. To adequately treat these patients, a high index of suspicion is needed to diagnose and treat the open fractures and to prevent complications such as infection, osteomyelitis, malunion and premature physeal arrest.We report a case of a patient that was admitted to the hospital with a Salter-Harris type I fracture of the distal phalanx of the hallux. After confirming the diagnosis, antibiotic treatment was started and the fracture was reduced and fixed.The literature on this entity is sparse and most of the management protocols are based on its hand equivalent—the Seymour fracture, emphasising the low threshold for treating these lesions as an open fracture.

Objective: This study aims to compare the use of halo-gravity traction (HGT) with and without previous anterior release, in terms of curve reduction, for the treatment of pediatric severe spinal deformity. Methods: From 2010 to 2016, all patients treated with HGT prior to instrumentation for scoliosis and kyphoscoliosis were reviewed. They were assessed by deformity etiology, previous anterior release, instrumentation procedure used, traction protocol, major Cobb angle before traction, after the protocol, and after the instrumentation procedure. Twelve patients met these criteria and constituted the sample groups: Group I (n=7) with anterior release and Group II (n=5) without anterior release. Results: The average pre-traction major curve Cobb angles were 114.9o and 108.4º for Group I and II, respectively (P>0.05). After HGT, both groups achieved a significant reduction in curve angle (P0.05). No major HGT related complications were reported. Conclusions: Anterior release prior to HGT did not increase major curve correction after posterior surgery for severe pediatric idiopathic and syndromic scoliosis. HGT is an effective and safe technique, though it frequently presents minor and transitory complications. Level of Evidence III; Retrospective Comparative Study.

The clear decline in the practice of physical activity (PA) in contemporary society has well-documented problematic consequences in public health. It has led to a clear investment of research efforts in the attempt to identify the psychological constructs associated with health behaviors such as PA, in particular, the motivation that leads people to adopt these behaviors. In this context, the objective of the present study is to present a suggestion of a Portuguese version of the Physical Activity and Leisure Motivation Scale (PALMS), denominated PALMS-p. This instrument evaluates the reasons for the practice of PA. The psychometric qualities of the instrument were evaluated in a sample of 234 participants (86 males, 148 females) who practiced different PA in a recreational context. Confirmatory factorial analysis confirmed the factorial robustness of the PALMS-p (&chi, 2/df = 2.010 comparative fit index (CFI) = 0.950, goodness of fit index (GFI) = 0.855, Tucker-Lewis Index (TLI) = 0.939 root-mean-square error of approximation (RMSEA) = 0.021, P(RMSEA &le, 0.05) &lt, 0.001), and the results show that this version presents good internal consistency. The present study corroborates the fidelity and validity of PALMS-p as a motivation measure for the practice of PA in the Portuguese population.

During pre and post graduation in Medicine, the traumatic aetiology concepts that guide the diagnosis and treatment of lesions in children (and adults) are often watered down in the immensity of medical knowledge to which medical students are subjected. Despite being frequently confronted with cases of paediatric traumatology, family physicians often feel they are poorly prepared to evaluate and treat these cases. In order to surpass these limitations, a few notions of physiopathology, epidemiology, semiology - common in a context of paediatric traumatology - are presented. Some general therapeutic principles that allow to solve a number of these situations are also discussed.