Zhang Lei, Zuo Yuming, Wang Yueguang, Zhou Hongyan, Wang Guoqiang, Yu Tieqiang, Yi Fan, Li Liang
Department of Pediatric Orthopedics, the Second Hospital of Tangshan, Tangshan Hebei, 063000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):529-531. doi: 10.7507/1002-1892.20160106.
To discuss the treatment method and effectiveness of Seymour fracture in children and adolescents.
Between January 2013 and November 2015, 26 children and adolescents with Seymour fractures were treated. There were 18 males and 8 females, aged from 1 year and 1 month to 17 years (median, 8.2 years). The injury causes included crush in 14 cases, bruise in 10 cases, and puncture in 2 cases. The thumb was involved in 2 cases, index finger in 1 case, middle finger in 12 cases, ring finger in 6 cases, and little finger in 5 cases. The time from injury to operation was 1-15 hours (mean, 3.2 hours). The patients underwent debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency. Kirschner wires and splints were removed at 4 weeks after surgery, and functional exercises were done.
All wounds healed by first intention without infection. The follow-up duration was 2-24 months (mean, 12.3 months). The fracture healing was obtained at 1-2 months (mean, 1.4 months) on X-ray film, and no complications of nonunion, malunion, re-displacement, premature epiphyseal closure, or no growth of the nails occurred. Nail deformity developed in 1 case and no re-operation was given. At last follow-up, 1 patient had 10° extension limitation of the distal interphalangeal joint, but the flexion was normal. The motion range of distal interphalangeal joint was 0-75°, showing no significant difference when compared with that of contralateral side (0-78°).
The effectiveness for treating Seymour fracture is satisfactory by debridement, nail removal, nail matrix repair, closed reduction and osteosynthesis with Kirschner wires, and splinting in emergency.
探讨儿童及青少年Seymour骨折的治疗方法及疗效。
2013年1月至2015年11月，对26例儿童及青少年Seymour骨折患者进行治疗。其中男性18例，女性8例，年龄1岁1个月至17岁（中位数8.2岁）。致伤原因包括挤压伤14例、挫伤10例、刺伤2例。拇指损伤2例，示指1例，中指12例，环指6例，小指5例。受伤至手术时间为1 - 15小时（平均3.2小时）。患者在急诊下行清创、拔甲、甲床修复、闭合复位克氏针内固定及夹板固定。术后4周拔除克氏针及去除夹板，并进行功能锻炼。
所有伤口均一期愈合，无感染发生。随访时间为2 - 24个月（平均12.3个月）。X线片显示骨折在1 - 2个月（平均1.4个月）愈合，未发生骨不连、畸形愈合、再移位、骨骺过早闭合或指甲不长等并发症。1例出现指甲畸形，未再次手术。末次随访时，1例患者远侧指间关节有10°伸直受限，但屈曲正常。远侧指间关节活动范围为0 - 75°，与对侧（0 - 78°）相比无显著差异。
采用清创、拔甲、甲床修复、闭合复位克氏针内固定及急诊夹板固定治疗Seymour骨折疗效满意。
