Pediatric Seymour Fractures of the Toe.

Szczegóły
Abstrakt

Tytuł:: Pediatric Seymour Fractures of the Toe.
Autorzy:: Baker CE; Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN.
Leafblad N
Larson AN
Źródło:: Journal of pediatric orthopedics [J Pediatr Orthop] 2021 Jan; Vol. 41 (1), pp. e55-e59.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2000- : Philadelphia : Lippincott Williams & Wilkins
Original Publication: New York Ny : Raven Press
MeSH Terms:: Fractures, Open/*complications
Nails/*injuries
Osteomyelitis/*etiology
Salter-Harris Fractures/*complications
Toes/*injuries
Adolescent ; Child ; Female ; Fractures, Open/therapy ; Humans ; Lacerations/complications ; Male ; Retrospective Studies ; Salter-Harris Fractures/therapy
References:: Seymour N. Juxta-epiphysial fracture of the terminal phalanx of the finger. J Bone Joint Surg Br. 1966;48:347–349.
Reyes BA, Ho CA. The high risk of infection with delayed treatment of open Seymour fractures: Salter-Harris I/II or juxta-epiphyseal fractures of the distal phalanx with associated nailbed laceration. J Pediatr Orthop. 2017;37:247–253.
Lin JS, Popp JE, Balch Samora J. Treatment of acute Seymour fractures. J Pediatr Orthop. 2019;39:e23–e27.
Pinckney LE, Currarino G, Kennedy LA. The stubbed great toe: a cause of occult compound fracture and infection. Radiology. 1981;138:375–377.
Kensinger DR, Guille JT, Horn BD, et al. The stubbed great toe: importance of early recognition and treatment of open fractures of the distal phalanx. J Pediatr Orthop. 2001;21:31–34.
Banks AS, Cain TD, Ruch JA. Physeal fractures of the distal phalanx of the hallux. J Am Podiatr Med Assoc. 1988;78:310–313.
Noonan KJ, Saltzman CL, Dietz FR. Open physeal fractures of the distal phalanx of the great toe. A case report. J Bone Joint Surg Am. 1994;76:122–125.
Abzug JM, Kozin SH. Seymour fractures. J Hand Surg Am. 2013;38:2267–2270; quiz 2270.
Entry Date(s):: Date Created: 20201210 Date Completed: 20210416 Latest Revision: 20210416
Update Code:: 20240104
DOI:: 10.1097/BPO.0000000000001676
PMID:: 33298716
: Czasopismo naukowe

Background: Seymour fractures of the toe are physeal fractures with often occult concomitant nail bed injuries and thus are open fractures. They are uncommon injuries that without proper treatment can result in osteomyelitis. The literature has sparse information regarding the clinical outcomes for these injuries.
Methods: A single-center retrospective review included juxta-epiphyseal fractures or Salter-Harris I/II fracture of the toe with documented concomitant nail bed injury or laceration. Clinical and radiographic data were recorded for consecutive fractures. The primary outcome was the incidence of osteomyelitis. Secondary outcomes included premature physeal arrest, development of nail dystrophy, and functionality of the toe.
Results: Between 2006 and 2019, 19 patients were treated for this injury by the pediatric orthopaedic division. Complications included osteomyelitis (n=6), physeal arrest (n=4), and nail dystrophy (n=1). Days from injury to definitive treatment were significantly greater in patients who developed osteomyelitis compared with those who did not (P<0.01). Patients were significantly more likely to develop osteomyelitis if they did not receive acute definitive treatment (<48 h) (P<0.001; likelihood ratio, 17.9).
Conclusions: Prompt definitive treatment of Seymour fractures of the toe was associated with a lower incidence of osteomyelitis. Greater awareness for these seemingly innocuous injuries is needed to provide an early treatment that may reduce the rate of osteomyelitis.
Level of Evidence: Level IV-case series.

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