On-field management of emergent and urgent extremity conditions

Extremity injuries are common in many sporting events. Properly treating these injuries consists of initial evaluation to determine a presumptive diagnosis and provision of appropriate management to decrease the risk of long-term sequelae. Evaluation for and treatment of neurologic and vascular compromise should always occur in the field as expeditiously as possible, taking care not to make the injury worse. Radiographs may be impractical or unnecessary prior to reduction of many injuries. In general, in-line traction and reduction is usually safe and may alleviate complications. Following field treatment, appropriate splinting is necessary to relieve pain and prevent complications during transport. Proper field management and referral of extremity conditions provides the best primary opportunity to avoid complications.