Two cases of treatment of the seymour fracture complicated by pyogenic arthritis with antibiotic-impregnated calcium phosphate paste granules

JOS Case Reports Pub Date : 2025-01-04 DOI:10.1016/j.joscr.2024.12.001

Koki Hosozawa , Ryoichi Shibuya , Satoshi Miyamura , Toru Iwahashi , Takeshi Fuji

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Abstract

Background

Seymour fractures are physeal fractures of the distal phalanx in children. These fractures are difficult to treat because they frequently lead to infections. We report two cases of Seymour fractures complicated by pyogenic arthritis, treated with vancomycin-impregnated paste granules of calcium phosphate cement, that showed good outcomes.

Case presentation

Two teenagers injured their fingers during rugby. They visited the outpatient clinic several days after the injury, presenting with purulent material discharge from the nail bed detachment. X-ray and MRI showed physeal fractures with associated inflammation, resulting in the diagnosis of Seymour fractures complicated by pyogenic arthritis and osteomyelitis. The wounds were irrigated and debrided, and the bone defect was filled with vancomycin-impregnated paste granules of calcium phosphate cement. While the growth plates closed prematurely, no recurrence of infection occurred.

Conclusion

In Seymour fractures complicated by pyogenic arthritis, vancomycin-impregnated paste granules of calcium phosphate cement are effective in controlling infection.

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浸渍磷酸钙糊粒治疗西摩骨折合并化脓性关节炎2例

背景：西摩骨折是儿童远端指骨的骨骺骨折。这些骨折很难治疗，因为它们经常导致感染。我们报告了两例西摩骨折合并化脓性关节炎的病例，用万古霉素浸渍磷酸钙水泥糊粒治疗，结果良好。两名青少年在橄榄球比赛中伤了手指。他们在伤后几天到门诊就诊，表现为甲床脱离排出脓性物质。x线及MRI显示骨骺骨折伴炎症，诊断为西摩骨折合并化脓性关节炎及骨髓炎。创面冲洗、清创，骨缺损用万古霉素浸渍磷酸钙水泥糊粒充填。生长板过早闭合时，未发生感染复发。结论对西摩骨折合并化脓性关节炎患者，应用万古霉素浸渍磷酸钙水泥膏体颗粒可有效控制感染。

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JOS Case Reports

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