Ugurlar M, Saka G, Saglam N, Milcan A, Kurtulmus T, Akpınar F
1Department of Orthopaedics and Traumatology, Umraniye Training and Research Hospital, Elmalıkent Mah, Istanbul, Turkey.
J Hand Surg Eur Vol. 2014 Mar;39(3):237-41. doi: 10.1177/1753193413510863. Epub 2013 Nov 4.
Seymour's fracture is an extra-articular, transverse, physeal, and juxta-epiphyseal open fracture of the distal phalanx seen in childhood. In this study, we present 10 adult cases of fractures localized to the metaphyseal region, 1-2 mm distal to the insertion of the extensor tendon. Mean age was 38 years. Four patients were treated conservatively with a mallet finger splint. Closed reduction and osteosynthesis with Kirschner wires (K-wires) was performed in three of the patients. Three of the patients had open fractures in whom closed reduction could not be performed. They underwent open reduction and osteosynthesis with K-wires. We recommend that extra-articular distal phalanx fractures mimicking mallet finger in adults are called Seymour-type fracture to establish a common language among clinicians to define this type of fracture. These fractures generally occur by hyperflexion of the distal phalanx and can be treated by conservative or surgical methods. The outcomes of conservative and surgical management of Seymour-type fractures depend on the appropriate reduction as well as efficient physical therapy.
西摩骨折是儿童期出现的远节指骨的关节外、横行、骨骺及近骨骺开放性骨折。在本研究中,我们报告了10例成人骨折病例,骨折位于干骺端区域,在伸肌腱止点远侧1 - 2毫米处。平均年龄为38岁。4例患者采用锤状指夹板保守治疗。3例患者进行了闭合复位并用克氏针内固定。3例患者为开放性骨折,无法进行闭合复位,他们接受了切开复位并用克氏针内固定。我们建议将成人中模仿锤状指的关节外远节指骨骨折称为西摩型骨折,以便临床医生之间建立一种通用的术语来定义这种骨折类型。这些骨折通常由远节指骨的过度屈曲引起,可采用保守或手术方法治疗。西摩型骨折保守和手术治疗的结果取决于适当的复位以及有效的物理治疗。