SEYMOUR FRACTURES

Question 1

Seymour fracture definition

Answer 1

Distal phalanx physeal fracture with associated nail bed injury

Question 2

Most common location for Seymour fractures

Answer 2

Middle finger

Question 3

Mechanism of injury for Seymour fractures

Answer 3

Crush injury

Question 4

Deformity in Seymour fractures

Answer 4

Apex dorsal or mallet deformity
Deforming forces:
1. Terminal extensor tendon
- attaches to epiphysis of distal phalanx
- pulls proximal fragment into extension
2. FDP tendon
- attaches to metaphysis of distal phalanx
- pulls distal fragment into flexion

Question 5

Differentiation between Seymour fractures and paediatric mallet fractures

Answer 5

Seymour fractures are SH I or II that do enter DIPJ

Paediatric bony mallets are SH III or IV

Question 6

4 main complications with Seymour fractures

Answer 6

1. Mallet deformity
2. Nail plate deformity
3. Premature physeal arrest
4. Chronic osteomyelitis