Fractures with CFSNBL (n=42) were treated with open reduction (OR) and splinting (n=25), OR and PP (n=13), CS (n=4).
Fractures without CFSNBL (n=30) were treated with closed reduction and splinting (CS) (n=24) and closed reduction and percutaneous pinning (PP) (n=6). At exploration, NBL was found in 31 (82%) fractures and soft tissue interposition in 18 (47%) (Table1). Among 42 fractures with CFSNBL, surgical exploration was undertaken in 38 fractures. CFSNBL were subungual hematoma (n=16), subluxation of proximal nail plate (n=13), laceration proximal to the eponychial fold (n=12), oozing of blood from underneath the nail plate (n=4), eponychial fold laceration (n=3), and near total/total nail plate avulsion (n=2). Forty-Two (58%) fractures had at least one clinical finding suggestive of NBL (CFSNBL).
Eighty percent presented within 24 hours of injury. SH 2 was the most common (n=50) followed by SH 3 (n=12) and SH 1 (n=10). Sport-related injuries accounted for 39 (54%) fractures. The thumb was the most commonly involved (n=21), followed by long (n=18), ring (n=17), small (n=9), and index (n=7). The right hand was involved in 43 fractures. Results: Seventy patients (74% male) were treated for 72 SH fractures at a mean±SD age of 11.3☓.7 years. Material and Methods: A retrospective review of patients with SH fractures of the DP treated between 20. We sought to review our experience and propose a treatment algorithm. Introduction: Salter-Harris (SH) fractures of the distal phalanx with or without evidence of nail bed laceration (NBL) are frequently undertreated. Mayo Clinic, Department of Plastic Surgery, Rochester, MN Waleed Gibreel, MBBS Ali Charafeddine, MD Karim Bakri, MBBS Salter-Harris Fractures of the Distal Phalanx: is it Time to Define Optimal Surgical Treatment?
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