Naslov
Osteomyelitis after epiphyseolysis of the distal phalanx of the hand

Autori
Jelčić, Ivan ; Papeš, Dino ; Pasini, Miram ; Sabolić, Ivana ; Dalipi, Aida ; Vlahek, Tomislav ; Ćavar, Stanko ; Antabak, Anko ; Luetić, Tomislav

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
9th Croatian Congress of Pediatric Surgery with International Participation - Book of abstracts / - , 2022, 128-128

Skup
9th Croatian Congress of Pediatric Surgery with International Participation

Mjesto i datum
Pula, Hrvatska, 21.09.2022. - 24.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
distal phalanx ; osteomyelitis

Sažetak
Dislocated and complicated epiphysolysis of distal phalanx with associated injury of the nail matrix and presence of „mallet“ deformity is called Seymour fracture. Treatment consists of reposition, matrix repair, and fixation of fracture. Seventeen-year-old boy was operated on for Seymour fracture sustained 4 days prior. Operative procedure consisted of wound irrigation, fixation with Kirschner wire, nail matrix repair and nail reposition with fixation. Seven day antibiotic treatment with oral clindamycin was initiated. Kirschner wire was removed after 20 days. Two months after initial treatment, distal phalnx started to show signs of infection (edema, redness and pain). X-ray confirmed osteolysis in base of the phalanx which was indicative of osteomyelitis. Another antibotic regimen was initiated, also with oral clindamycin over the course of 4 weeks. Since the symptoms persisted, surgical debridement was performed along with daily topical administration of gentamicin for 10 days and another course of oral clindamycin. Surgical dressing was changed daily for 10 days after which nail matrix was approximated with suttures. Two year follow up showed no sign of regression with completely functional distal interphalangeal joint and a healthy looking nail. Osteomyelitis after distal phalanx Seymour fracture is not common. If not treated properly it can lead to arthrodesis of distal interphalangeal joint, nail deformity and in the most severe cases end with finger or distal phalanx amputation. Differential diagnosis includes inclusion cyst of the nail matrix. Surgical treatment can yield good functional and esthetic outcome.

Izvorni jezik
Engleski

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