Severe Pain On Passive in Surgery — 32yo Man | Trauma Surgery | SMLE Q#939

SMLE Question #939

Surgery Trauma Surgery

Objective: OBJ-TRM-AIRWAY-01

Last updated: February 2026
A 32-year-old man presents to the emergency department 3 hours after his right forefoot was crushed under a heavy metal beam at work. He reports excruciating, worsening pain that is out of proportion to the visible injury and not relieved by IV opioids. Examination shows a tense, pale, cool forefoot with severe pain on passive toe extension; the dorsalis pedis pulse is faintly palpable. What is the best next step in management?

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