Seymour's Fracture in a 13-years-old Child: A Case Report

A nail bed injury concomitant with an underlying physeal injury of the distal phalanx is termed as "Seymour's fracture." These are seemingly innocuous injuries commonly misdiagnosed and are subsequently under-treated. These injuries demand treatment like an open fracture to prevent complications such as infection, growth arrest, and nail dystrophies.

A 13-year-old boy suffered Seymour's fracture of the left ring finger distal phalanx after a direct injury from a dodge ball. The fracture was treated with thorough debridement with normal saline, physeal injury reduction through the wound, and fixation with k-wire passed through the tip of the ring finger, metaphysic, physis, and the tip of the k-wire ending in the epiphysis of the distal phalanx. The nail bed was sutured with 3-0 monofilament absorbable sutures. The fracture healed at 3 months and a 1-year follow-up showed a completely formed nail without any deformity.

Excellent outcome was observed with debridement of the wound, nail bed repair, and fixation with k-wire in our case. Nail bed injuries in children should be treated with a high index of suspicion for Seymour's fracture as it necessitates treatment like that of an open fracture to avoid complications.