SURGICAL TREATMENT OF Seymour FRACTURES IN CHILDREN AND ADOLESCENTS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 ZHANGLei , ZUOYuming , WANGYueguang , ZHOUHongyan , WANGGuoqiang , YUTieqiang , YIFan , LILiang

Department of Pediatric Orthopedics, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China;

Corresponding author：

ZHANGLei, Email: xp30000@sina.com

Keywords：

Seymour fracture; Internal fixation; Nail matrix; Premature epiphyseal closure; Children; Adolescent

DOI：

10.7507/1002-1892.20160106

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Objective To discuss the treatment method and effectiveness of Seymour fracture in children and adolescents. Methods Between January 2013 and November 2015, 26 children and adolescents with Seymour fractures were treated. There were 18 males and 8 females, aged from 1 year and 1 month to 17 years (median, 8.2 years). The injury causes included crush in 14 cases, bruise in 10 cases, and puncture in 2 cases. The thumb was involved in 2 cases, index finger in 1 case, middle finger in 12 cases, ring finger in 6 cases, and little finger in 5 cases. The time from injury to operation was 1-15 hours (mean, 3.2 hours). The patients underwent debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency. Kirschner wires and splints were removed at 4 weeks after surgery, and functional exercises were done. Results All wounds healed by first intention without infection. The follow-up duration was 2-24 months (mean, 12.3 months). The fracture healing was obtained at 1-2 months (mean, 1.4 months) on X-ray film, and no complications of nonunion, malunion, re-displacement, premature epiphyseal closure, or no growth of the nails occurred. Nail deformity developed in 1 case and no re-operation was given. At last follow-up, 1 patient had 10° extension limitation of the distal interphalangeal joint, but the flexion was normal. The motion range of distal interphalangeal joint was 0-75°, showing no significant difference when compared with that of contralateral side (0-78°). Conclusion The effectiveness for treating Seymour fracture is satisfactory by debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency.

Citation： ZHANGLei, ZUOYuming, WANGYueguang, ZHOUHongyan, WANGGuoqiang, YUTieqiang, YIFan, LILiang. SURGICAL TREATMENT OF Seymour FRACTURES IN CHILDREN AND ADOLESCENTS. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 529-531. doi: 10.7507/1002-1892.20160106 Copy

1.	Seymour N. Juxta-epiphysial fracture of the terminal phalanx of the finger. J Bone Joint Surg (Br), 1966, 48(2):347-349.
2.	Goldie SJ, Sargeant HW, Medjoub K, et al. A footballer's finger injury. BMJ, 2013, 347:f5069.
3.	Onur B, Bijayendra S. A unique physeal injury of the distal phalanx. Cas Rep Plast Surg Hand Surg, 2015, 2(1):4-6.
4.	Al-Qattan MM. An unusual Salter type 2 fracture of the distal phalanx. J Hand Surg (Br), 1998, 23(2):283-284.
5.	Ganayem M, Edelson G. Base of distal phalanx fracture in children:a mallet finger mimic. J Pediatr Orthop, 2005, 25(4):487-489.
6.	Han C, Naito K, Sugiyama Y, et al. Bony mallet finger without epiphyseal plate injury in childhood. Int J Surg Case Rep, 2015, 14:172-174.
7.	Waters PM, Benson LS. Dislocation of the distal phalanx epiphysis in toddlers. J Hand Surg (Am), 1993, 18(4):581-585.
8.	Lee S, Kim M, Jeon SH. Dislocation of the unossified epiphysis of the distal phalanx of a finger. J Hand Surg (Eur Vol), 2012, 37(5):465-466.
9.	Michelinakis E, Vourexaki H. Displaced epiphyseal plate of the terminal phalanx in a child. Hand, 1980, 12(1):51-53.
10.	朱立帆, 徐浩, 张晓剑, 等. 锚钉修复法与改良缝合法治疗锤状指的疗效比较. 中国修复重建外科杂志, 2012, 26(9):1077-1080.
11.	王文凯, 武洁, 李仕国, 等. 微型骨锚在新鲜锤状指畸形治疗中的临床应用. 中国实用医药, 2016, 11(1):90-91.
12.	Papadonikolakis A, Li Z, Smith BP, et al. Fractures of the phalanges and interphalangeal joints in children. Hand Clin, 2006, 22(1):11-18.
13.	Al-Qattan MM. Extra-articular transverse fractures of the base of the distal phalanx (Seymour's fracture) in children and adults. J Hand Surg (Br), 2001, 26(3):201-206.
14.	Ugurlar M, Saka G, Saglam N, et al. Distal phalanx fracture in adults:Seymour-type fracture. J Hand Surg (Eur Vol), 2014, 39(3):237-341.
15.	Inoue G. Irreducible palmar epiphyseal fracture-dislocation of the distal interphalangeal joint of a finger. Arch Orthop Trauma Surg, 1992, 111(4):244-245.
16.	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, 2015.[Epub ahead of print].
17.	Abzug JM, Kozin SH. Seymour fractures. J Hand Surg (Am), 2013, 38(11):2267-2270.
18.	Krusche-Mandl I, Kottstorfer J, Thalhammer G, et al. Seymour fractures:retrospective analysis and therapeutic considerations. J Hand Surg (Am), 2013, 38(2):258-264.

1. Seymour N. Juxta-epiphysial fracture of the terminal phalanx of the finger. J Bone Joint Surg (Br), 1966, 48(2):347-349.
2. Goldie SJ, Sargeant HW, Medjoub K, et al. A footballer's finger injury. BMJ, 2013, 347:f5069.
3. Onur B, Bijayendra S. A unique physeal injury of the distal phalanx. Cas Rep Plast Surg Hand Surg, 2015, 2(1):4-6.
4. Al-Qattan MM. An unusual Salter type 2 fracture of the distal phalanx. J Hand Surg (Br), 1998, 23(2):283-284.
5. Ganayem M, Edelson G. Base of distal phalanx fracture in children:a mallet finger mimic. J Pediatr Orthop, 2005, 25(4):487-489.
6. Han C, Naito K, Sugiyama Y, et al. Bony mallet finger without epiphyseal plate injury in childhood. Int J Surg Case Rep, 2015, 14:172-174.
7. Waters PM, Benson LS. Dislocation of the distal phalanx epiphysis in toddlers. J Hand Surg (Am), 1993, 18(4):581-585.
8. Lee S, Kim M, Jeon SH. Dislocation of the unossified epiphysis of the distal phalanx of a finger. J Hand Surg (Eur Vol), 2012, 37(5):465-466.
9. Michelinakis E, Vourexaki H. Displaced epiphyseal plate of the terminal phalanx in a child. Hand, 1980, 12(1):51-53.
10. 朱立帆, 徐浩, 张晓剑, 等. 锚钉修复法与改良缝合法治疗锤状指的疗效比较. 中国修复重建外科杂志, 2012, 26(9):1077-1080.
11. 王文凯, 武洁, 李仕国, 等. 微型骨锚在新鲜锤状指畸形治疗中的临床应用. 中国实用医药, 2016, 11(1):90-91.
12. Papadonikolakis A, Li Z, Smith BP, et al. Fractures of the phalanges and interphalangeal joints in children. Hand Clin, 2006, 22(1):11-18.
13. Al-Qattan MM. Extra-articular transverse fractures of the base of the distal phalanx (Seymour's fracture) in children and adults. J Hand Surg (Br), 2001, 26(3):201-206.
14. Ugurlar M, Saka G, Saglam N, et al. Distal phalanx fracture in adults:Seymour-type fracture. J Hand Surg (Eur Vol), 2014, 39(3):237-341.
15. Inoue G. Irreducible palmar epiphyseal fracture-dislocation of the distal interphalangeal joint of a finger. Arch Orthop Trauma Surg, 1992, 111(4):244-245.
16. 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, 2015.[Epub ahead of print].
17. Abzug JM, Kozin SH. Seymour fractures. J Hand Surg (Am), 2013, 38(11):2267-2270.
18. Krusche-Mandl I, Kottstorfer J, Thalhammer G, et al. Seymour fractures:retrospective analysis and therapeutic considerations. J Hand Surg (Am), 2013, 38(2):258-264.

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SURGICAL TREATMENT OF Seymour FRACTURES IN CHILDREN AND ADOLESCENTS

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