Seymour Fracture (Fingertip)

Description

A Seymour fracture is a break of the growth plate at the very tip of a finger, combined with an injury to the nail bed, where the base of the nail often pops up out of its fold. It usually happens from a crush, such as a finger caught in a door. Though it can look like a simple smashed fingertip, it is more than that.

How it happens (the mechanism)

This is usually a crush, like a finger caught in a door or hit by a ball. The fingertip bone bends at its growth plate, which tears the nail bed that sits right on top of it. The base of the nail lifts out of its fold, and a flap of nail bed can get caught inside the break. Because the skin and nail bed are torn right over the fracture, the bone is open to the outside, even when the wound looks small. That makes it an open fracture, with a real risk of bone infection. Nail bed caught in the break also keeps the bone from lining up. If it is treated like a simple jammed finger, it can lead to infection, a crooked fingertip, early closing of the growth plate, or a misshapen nail.

Symptoms

A painful, swollen fingertip after a crush, often with the nail lifted out of its fold, bleeding at the nail base, or the tip bent down.

Doctor examination and imaging

The doctor examines the nail and skin and the position of the fingertip; X-rays show the growth-plate fracture at the tip.

Treatment

This is treated as an open injury: the wound is thoroughly cleaned, the nail bed and bone are repositioned (sometimes with a small pin), and antibiotics are given. This is often best done soon after the injury, and a splint then protects the fingertip.

Recovery and long-term outlook

Treated promptly and properly, a Seymour fracture does well. Recognizing it early is what prevents infection and protects the fingertip’s growth and the future nail.

When to call the doctor

Because the bone and a skin wound are both involved, infection is the main concern. Watch for increasing redness, swelling, warmth, pus or drainage, worsening pain, or fever, and call right away or go to the emergency room if any appear. Give all antibiotics exactly as prescribed.

Learn more

OrthoInfo (AAOS), Growth Plate Fractures: orthoinfo.aaos.org (opens in a new tab)

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.