Halverson Jake C, Cornelson Stacey M, Murray Quintin W, Kettner Norman W
Radiology Department, Logan University, Chesterfield, Missouri.
Montgomery Health Center, Logan University, Chesterfield, Missouri.
J Chiropr Med. 2021 Dec;20(4):218-223. doi: 10.1016/j.jcm.2021.12.006. Epub 2022 Apr 6.
The purpose of this report is to describe the clinical, radiographic, and diagnostic ultrasound findings in a patient who sustained a type III Salter-Harris fracture of the first proximal phalanx.
A 14-year-old male baseball player presented to a chiropractic clinic with a 2-day history of proximal thumb pain, which began following a forceful hyperabduction injury while sliding into base. Thenar swelling was evident on clinical examination, and both active and passive thumb motions were painful in all directions. Radiography revealed a type III Salter-Harris fracture of the first proximal phalangeal base. Additionally, diagnostic ultrasonography demonstrated a probable high-grade ulnar collateral ligament sprain. No further displacement of the fracture fragment was visualized with radial deviation stress.
The patient was referred to a pediatric hand orthopedic specialist for consultation and treatment.
Salter-Harris III fractures of the thumb base warrant special attention to various clinical and imaging features, which may affect patient outcomes. Fracture characterization with radiography is essential in determining the proper management. Ultrasonography and magnetic resonance imaging may be useful in the evaluation of concomitant soft tissue injuries, as demonstrated in this case report.
本报告旨在描述一名第一近节指骨发生III型Salter-Harris骨折患者的临床、影像学及诊断性超声检查结果。
一名14岁的男性棒球运动员因拇指近端疼痛2天就诊于一家整脊诊所，疼痛始于滑垒时强力外展损伤之后。临床检查发现大鱼际肿胀，拇指的主动和被动活动在各个方向均疼痛。X线检查显示第一近节指骨基底III型Salter-Harris骨折。此外，诊断性超声检查显示可能存在高度尺侧副韧带扭伤。在桡侧偏斜应力下未见骨折碎片进一步移位。
该患者被转诊至小儿手部整形外科专家处进行咨询和治疗。
拇指基底的Salter-Harris III型骨折需要特别关注各种临床和影像学特征，这些特征可能影响患者预后。通过X线检查进行骨折特征描述对于确定恰当的治疗至关重要。如本病例报告所示，超声检查和磁共振成像在评估合并的软组织损伤方面可能有用。
