Emergency Cases Northwest Group

082 Seymour Than A Fracture

Situation

A child had an open fracture of the big toe.

Background

A 9 year old girl suffered an injury to the big toe playing football the week before. The toe was swollen and bruised, some apparent injury to the nail bed too. X-ray showed displaced fracture as in the X-ray below. The patient was referred to orthopaedics for antibiotics, wound assessment and k-wire reduction in theatre.

Ref: https://brownemblog.com/blogposts/2018/8/24/do-you-see-more-fractures-dont-overlook-seymour-fractures

Assessment

This was a Seymour fracture: this is when there is Salter-Harris 1 or 2 fracture (or slightly more distal fracture) of the distal phalanx of a digit, but associated with injury to the nail bed thus technically an open fracture.

Recommendation

Be aware that digit injuries that resemble X-rays like this may be Seymour fractures. Look for nail bed injuries that may represent an open fracture. The surgeon must look for interposed soft tissue in the fracture site, with osteomyelitis a possible complication.

Ref: https://upload.orthobullets.com/journalclub/free_pdf/24206995.pdf

Source Dr Mahmad Vaigamiya

PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED IMAGES

Emergency Cases Northwest Group