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

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.