EXTRA-ARTICULAR TRANSVERSE FRACTURES OF THE BASE OF THE DISTAL PHALANX (SEYMOUR’S FRACTURE) IN CHILDREN AND ADULTS

2001 ◽  
Vol 26 (3) ◽  
pp. 201-206 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Growth Plate ◽  
Closed Reduction ◽  
Excellent Result ◽  
Extensor Tendon ◽  
Distal Phalanx ◽  
Adult Patients ◽  
Fracture Line ◽  
Wire Fixation ◽  
Adolescents And Adults ◽  
Transverse Fractures

A series of 25 extra-articular transverse fractures of the base of the distal phalanx (Seymour’s fracture) in children, adolescents and adults are presented. Prior to closure of the distal phalangeal epiphysis, the fracture line is usually entirely through the metaphyses, 1 to 2 mm distal to the growth plate. In adults, the fracture line is just distal to the insertion of the extensor tendon. Eighteen of these fractures were treated by closed reduction and splinting and one of these developed an infection and three had mild residual flexion deformities of the finger. Five fractures were treated by K-wire fixation and all healed without complications. Two adult patients presented 4 to 5 weeks after injury with malunion, and of these one underwent refracturing and K-wire fixation with an excellent result.

Distal phalanx fracture in adults: Seymour-type fracture

2013 ◽  
Vol 39 (3) ◽  
pp. 237-241 ◽  
Author(s):  
M. Ugurlar ◽  
G. Saka ◽  
N. Saglam ◽  
A. Milcan ◽  
T. Kurtulmus ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Fracture ◽  
Extensor Tendon ◽  
Distal Phalanx ◽  
Mallet Finger ◽  
Surgical Methods ◽  
Type Fracture ◽  
K Wires ◽  
Type Of Fracture ◽  
Metaphyseal Region

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.

Impacted tooth in mandibular fracture line: treatment with closed reduction

2004 ◽  
Vol 62 (3) ◽  
pp. 289-291 ◽  
Author(s):  
Timuçin Baykul ◽  
Erdal Erdem ◽  
Dogan Dolanmaz ◽  
Alper Alkan
Keyword(s):  
Closed Reduction ◽  
Mandibular Fracture ◽  
Fracture Line ◽  
Line Treatment ◽  
Impacted Tooth

Correction of Fixed Hammertoe Deformity with Resection of the Head of the Proximal Phalanx and Extensor Tendon Tenodesis

1995 ◽  
Vol 16 (7) ◽  
pp. 449-451 ◽  
Author(s):  
Shahan K. Sarrafian
Keyword(s):  
Proximal Phalanx ◽  
Extensor Tendon ◽  
Surgical Correction ◽  
Wire Fixation

A method of surgical correction of a fixed hammertoe deformity is presented. It incorporates the resection of the head of the proximal phalanx with an extensor tendon tenodesis to the dorsum of the proximal phalanx. The controlled tension in the extensor tendon provides the necessary stability. It alleviates the use of K-wire fixation.

Distal interphalangeal Joint Arthrodesis using only Kirschner Wires in small distal Phalanges

2021 ◽  
Vol 53 (05) ◽  
pp. 462-466
Author(s):  
Jun-Ku Lee ◽  
Soonchul Lee ◽  
SeongJu Choi ◽  
Dong Hun Han ◽  
Jongbeom Oh ◽  
...  
Keyword(s):  
Distal Phalanx ◽  
Bony Union ◽  
Dash Score ◽  
Medical Database ◽  
X Ray ◽  
Wire Fixation ◽  
Distal Interphalangeal ◽  
K Wires ◽  
Quick Dash

Abstract Purpose To report the clinical and radiographic results of arthrodesis of relatively small-sized distal interphalangeal joints (DIPJs) using only K-wire fixation. Patients and methods Between January 2000 and December 2018 28 arthrodesis in 21 patients (9 males and 12 females with an average age of 52.1 years) with relatively small-sized DIPJs were performed using only K-wires. Data on patient’s characteristics, such as age, sex, affected finger, and the number and size of the used k-wires were collected from the medical database. The narrowest diameter of the cortex and medulla of the distal phalanx was measured on preoperative plain radiographs. The time to union and the arthrodesis angle was determined using serial X-ray radiography follow-up. Preoperatively and at the latest follow-up examination, pain using the visual analogue scale (VAS) and the quick DASH score was registered. In addition, complications were investigated. Results Average follow-up period was 11.4 months. The small finger was mostly affected (n = 12; 42.9 %). The narrowest diameters of the distal phalanx cortex and the medulla measured on preoperative X-ray images were 2.8 mm (SD 0.5) and 1.2 mm (SD 0.4), respectively. Seven fusions were done with use of 1 K-wire, 20 with 2 (71.4 %), and 1 with 3 K-wires. The most common K-wire sizes were 1.1-inch (24 K-wires = 48 %), and 0.9 inch (21 K-wires = 42 %) The preoperative VAS score and quick DASH score improved from 6.1 (range: 0–9) and 25.8 (range: 2–38) to 0.4 (range: 0–2) and 3.4 (range: 0–10.2), respectively. 25 (89.3 %) out of 28 fingers achieved bony union in an average of 96.1 days (range: 58–114) with three non-union. Conclusion Arthrodesis of small DIPJs with K-wire fixation has a high success rate. Therefore, we suggest K-wire fixation as an acceptable alternative for patients with a small phalanx which may be at risk of mismatch with bigger implants. However, concerns remain in terms of fusion delay with K-wire only fixation.

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

scholarly journals A prospective study of distal radius fracture management by close reduction, percutaneous Kirschner wire fixation and plaster immobilization

2017 ◽  
Vol 3 (3) ◽  
pp. 537
Author(s):  
Abhishek Chattopadhyay ◽  
Upal Banerjee ◽  
Prashant Kumar Sinha ◽  
Subarna Misra ◽  
Ananya Chattopadhyay ◽  
...  
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Excellent Result ◽  
Kirschner Wire ◽  
Radius Fracture ◽  
Invasive Technique ◽  
Fair Result ◽  
Kirschner Wire Fixation ◽  
Wire Fixation ◽  
Plaster Immobilization

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Distal radius fracture is one of the most common fractures. It may be sustained due to low-energy trauma or high-energy trauma. Objectives: To compare the clinical effectiveness of Kirschner wire fixation with and plaster immobilization for patients with fracture of the distal radius.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Interventions Kirschner wire fixation: wires are passed through the skin over the dorsal aspect of the distal radius and into the bone to hold the fracture in the correct anatomical position. About 79 patients with Distal Radial Fractures presented to MGM Medical College and LSK Hospital, Kishanganj between November 2012 and June 2014 were included in the study</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The majority were men (60.4%). Majority of the patients (69.8%) sustained the injury due to fall. The side of involvement was nearly equal and that there was no predominance of the either sides. In our study, according to AO classification, 31 cases were of Type A, 17 were of Type B and 5 were of Type C. The Anatomical evaluation by Sarmiento’s Criteria showed 33 patients with excellent result, 15 patients with good result and 5 with a fair result. At final follow-up by ‘The Gartland and Werley criteria for functional outcome’ 37 patients had excellent result, 13 had good result, 2 had fair result and 1 had a poor result. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">This study demonstrates that percutaneous Kirschner<strong> </strong>wire pinning is a minimally invasive technique that provides an effective means of maintaining the anatomical<strong> </strong>fracture reduction. It does not required highly skilled<strong> </strong>personnel or sophisticated tools for application. It is a<strong> </strong>suitable method for fixation of displaced Colles fracture with minimal intra-articular involvement. The technique involves a minimal procedure that provides anatomic reduction, fracture fixation, and maintenance of reduction with an adequate method of immobilization.</span></p>

Long-Term Evaluation of Bennett’s Fracture

1994 ◽  
Vol 19 (3) ◽  
pp. 373-377 ◽  
Author(s):  
E. J. F. TIMMENGA ◽  
T. J. BLOKHUIS ◽  
M. MAAS ◽  
E. L. F. B. RAAIJMAKERS
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Bennett’S Fracture ◽  
Wire Fixation ◽  
Term Evaluation ◽  
Restricted Mobility ◽  
Almost All

18 patients with Bennett’s fracture were evaluated after a mean follow-up period of 10.7 years. Treatment consisted of closed reduction and K-wire fixation in seven cases and open reduction with osteosynthesis in 11 cases. Overall, symptoms were few and restricted mobility of the thumb could not be demonstrated. The strength of the affected hand was decreased in all patients regardless of the type of treatment. Osteoarthritis was found to correlate with the quality of reduction of the fracture, but had developed in almost all cases even after exact reduction. Exact reduction, either by the open or closed method, should be the aim of treatment of Bennett’s fracture.

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