The Journal of family practice
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To determine whether the clinical outcome of buckle fractures in children differs between those treated acutely on the same day of trauma and those treated subacutely, and whether a change in practice patterns based on these data would result in cost savings. ⋯ No adverse clinical outcomes resulted from subacute treatment of stable buckle fractures. Cost and time savings may be realized with subacute management of buckle fractures without affecting clinical outcome.
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Initiate antiviral treatment as soon as possible; rapid resolution of acute pain and reduction in the development of postherpetic neuralgia (PHN) are most likely when therapy is started within 72 hours of the outbreak. Discuss herpes zoster (HZ) vaccination with healthy patients 60 years of age and older during their first office visit; the vaccine markedly reduces the incidence of HZ and PHN. Do not prescribe tricyclic antidepressants or corticosteroids in the acute phase of HZ.