Seymour Fracture (Open Physeal Fracture of the Distal Phalanx)
Seymour fracture is a displaced distal phalanx juxta-epiphyseal fracture (Salter-Harris I or II) with an associated nail bed injury. Because of the nail bed injury, this is an open fracture and must be treated accordingly. Its diagnosis is often missed or delayed resulting in long-term complications that can include osteomyelitis, nail growth disturbance, and growth arrest of the distal phalanx. Diagnosis requires knowledge of and appropriate suspicion of the injury. Clinically, the injury resembles a mallet injury but with the nail often lying on top of the cuticle or bleeding from the cuticle noted. Radiographs can then confirm the presence of a displaced distal phalanx fracture. This fracture then must be treated as any other open fracture with antibiotics, irrigation and debridement, stabilization when needed, and appropriate immobilization.
References and Suggested Reading
- Reyes B, Ho CA (2015) 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 nail bed laceration. J Pediatr Orthop 00:000–000Google Scholar
- Seymour S (1966) Juxta-epiphyseal fracture of the terminal phalanx of the finger. JBJS 48(2):347–349Google Scholar