Seymour Fractures and Bony Mallet Fractures in the Pediatric Population

Abstract

Phalangeal fractures account for approximately 65% of all pediatric hand fractures. Fractures about the physeal region are particularly common due to the biomechanically weak nature of the cartilaginous physis compared to the surrounding ligaments and bones. A Seymour fracture is a juxta-epiphyseal fracture of the distal phalanx with an associated nail bed laceration. The fracture is managed through operative intervention by removing interposed soft tissue and reducing the fracture site. A bony mallet fracture is an intra-articular avulsion fracture at the site of attachment of the extensor tendon on the epiphysis. The management of the fracture is dependent on the severity of the injury and the success of a closed reduction. A nondisplaced phalanx fracture may be successfully managed through immobilization, while an unstable, displaced fracture requires surgical management often via closed reduction and percutaneous pinning. Common complications of these injuries include osteomyelitis, stiffness, extensor lag, and nail deformity.