Seymour fracture: Better do not underestimate it

Area of Science:

• Pediatric Orthopedics
• Traumatology
• Surgical Innovation

Background:

• Seymour fractures, a specific type of pediatric distal phalanx fracture, often involve the epiphysis.
• Management and potential sequelae of these fractures remain areas of clinical interest and debate.

Purpose of the Study:

• To analyze functional outcomes, management strategies, and complications associated with acute Seymour fracture treatment.
• To enhance understanding and awareness of Seymour fractures and their critical sequelae.

Main Methods:

• Retrospective analysis of 29 pediatric patients diagnosed with Seymour fractures within 24 hours of injury.
• Data collection included clinical and radiological assessments during follow-up until fracture healing or for at least one year if complications arose.

Main Results:

• Surgical treatment (Kirschner wire fixation) was performed in 82.7% of patients; non-operative treatment in 17.3%.
• No significant difference in range of motion or physeal growth arrest was observed between Kirschner wire use and non-use.
• Antibiotic use demonstrated a protective effect against infections (OR=0.04, p=0.001).

Conclusions:

• Accurate identification of Seymour fractures is vital for appropriate treatment and complication avoidance.
• Prophylactic antibiotic regimens appear to lower infection risk in acute Seymour fractures.
• A standardized protocol including irrigation, debridement, reduction, fixation, and prophylactic antibiotics is recommended.