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The stubbed great toe: a cause of occult compound fracture and infection
Radiology
|February 1, 1981
Insights
Stubbing injuries in children can cause hidden fractures of the great toe
Area of Science:
- Pediatric Orthopedics
- Pediatric Infectious Diseases
Background:
- Salter I fractures of the distal phalanx of the great toe are often caused by stubbing injuries.
- These fractures can present with subtle signs, potentially leading to delayed diagnosis and treatment.
Purpose of the Study:
- To investigate the nature of distal phalanx fractures in children resulting from stubbing injuries.
- To highlight the potential for occult compound fractures and associated infectious complications.
Main Methods:
- Retrospective case series of six children with Salter I distal phalanx fractures.
- Clinical presentation, treatment, and outcomes were analyzed.
- Anatomical review of the distal phalanx and nail relationship.
Main Results:
- Four children developed cellulitis and osteomyelitis after stubbing injuries.
- Two children treated promptly with antibiotics showed no signs of infection.
- Anatomical analysis suggested these fractures are often compound despite lacking typical signs.
Conclusions:
- Distal phalanx fractures from stubbing injuries should be considered occult compound fractures.
- Prompt antibiotic treatment is crucial to prevent infectious complications like osteomyelitis.
- Early recognition and management can significantly improve patient outcomes.
Abstract:
Six children suffered Salter I fractures of the distal phalanx of a great toe caused by stubbing. The first four children presented with cellulitis and osteomyelitis. The last two were treated promptly with antibiotics, and no infection developed. Analysis of the anatomic relationship of the distal phalanx and nail indicates that these fractures were compound despite the absence of usual clinical signs. Recognition of these occult compound fractures and treatment with antibiotics should prevent infectious complications.