Document Detail


Seymour fractures: retrospective analysis and therapeutic considerations.
MedLine Citation:
PMID:  23351909     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
PURPOSE: To analyze the management of Seymour fractures (juxta-epiphyseal fractures of the terminal phalanx of the finger in conjunction with flexion deformity at the fracture site, laceration of the nail bed, and frequently ungual subluxation) and to determine clinical and radiographic results following operative or conservative treatment.
METHODS: Clinical and radiological results of 24 skeletally immature patients (7 girls and 17 boys; mean age, 8.5 y) with Seymour fractures were evaluated. Assessment after a mean follow-up of 10 years (range, 1-18 y) included the range of motion, the modified Kapandji index, growth disturbance of the effected digit and nail, pain according to the visual analog scale, and patients' satisfaction.
RESULTS: Nine patients received nonoperative treatment. Operative management included debridement, open reduction, and fixation in 9. Owing to instability, an additional K-wire passing across the distal interphalangeal joint was used in 5. In 1 patient, the nail was removed. All surgically treated patients received a splint and perioperative cephalosporin. Twenty-three patients out of 24 gained full motion (mean, 80°; range, 65°-90°). The average modified Kapandji index was 5.0 for extension and 4.8 for flexion. Long-term minor growth disturbance of the distal phalanx (seen on radiographs at high amplification only) and nail were noted in 5 patients, and solitary nail dystrophies were observed in 6 patients. Nine of the 11 nail growth irregularities were not a relevant cosmetic problem for the patients. Patients' satisfaction assessment revealed a good clinical outcome. There was neither flexion deformity nor infection in our collective. At the 1-year follow-up examination, the average visual analog score was 0.6 (range, 0-2).
CONCLUSIONS: According to the literature, the Seymour fracture is an often-underestimated injury, and open cases are prone to infection. Evaluation of the outcome in our collective demonstrated good results with the treatment approaches described.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
Authors:
Irena Krusche-Mandl; Julia Köttstorfer; Gerhild Thalhammer; Silke Aldrian; Jochen Erhart; Patrick Platzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of hand surgery     Volume:  38     ISSN:  1531-6564     ISO Abbreviation:  J Hand Surg Am     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609631     Medline TA:  J Hand Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  258-64     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Trauma Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: irena.krusche-mandl@meduniwien.ac.at.
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