The Stubbed Great Toe: Importance of Early Recognition and Treatment of Open Fractures of the Distal Phalanx

Kensinger, Daniel R.; Guille, James T.; Horn, B. David; Herman, Martin J.

doi:10.1097/01241398-200101000-00008

Cited by 33 publications

(9 citation statements)

References 3 publications

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“…5 Despite the high prevalence of these injuries, literature regarding treatment outcomes and prognostic factors are lacking. 2 Two reports warn of the risk of osteomyelitis, especially when there are signs of open fracture by a direct injury mechanism and a delay in treatment. 2,5 Through irrigation, primary closure of wounds, and appropriate intravenous antibiotics, we did not experience osteomyelitis.…”

Section: Discussionmentioning

confidence: 98%

“…[1][2][3] The literature, however, contains very few articles reporting this type of injury. 1,2 Jahss 4 categorized stubbing injuries to the hallux by injury mechanism, yet it was based on only 6 subjects, and all of them were adults. Considering the wide array of injury patterns, previous reports fail to explain all mechanisms of injury in pediatric patients.…”

Section: Introductionmentioning

confidence: 94%

“…5 Some authors suggest open fractures in stubbing injuries of the great toe to be an important prognostic factor, which may lead to osteomyelitis without proper attention. 2,6 Yet these reports are based on small-sized case series in which antibiotic usage was delayed.…”

Section: Introductionmentioning

confidence: 95%

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Barefoot Stubbing Injuries to the Great Toe in Children

Park

Han

et al. 2013

Journal of Orthopaedic Trauma

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 94%

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Barefoot Stubbing Injuries to the Great Toe in Children

Park

Han

et al. 2013

Journal of Orthopaedic Trauma

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“…In fact, the layer of skin between nail and bone is the thinnest directly above the physis, where the germinal matrix of the nail (specialised inner layers of epidermis) and a shallow layer of dermis at the base of the nail would easily disrupt and allow the occurrence of an open physeal fracture. [1][2][3][4] These lesions may be hidden from view because skin and toenails of the paediatric population are, in many cases, a very soiled region. For the same reason, the risk of contamination and infection is enhanced.…”

Section: Discussionmentioning

confidence: 99%

Pinckney fracture: do not underestimate trauma of the distal phalanx of the hallux

et al. 2021

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Toe injuries are common in the emergency department and most of them are treated conservatively. In some circumstances, these injuries can present as a physeal fracture with concomitant soft-tissue injury affecting the nail bed and resulting in a hidden open fracture. To adequately treat these patients, a high index of suspicion is needed to diagnose and treat the open fractures and to prevent complications such as infection, osteomyelitis, malunion and premature physeal arrest.We report a case of a patient that was admitted to the hospital with a Salter-Harris type I fracture of the distal phalanx of the hallux. After confirming the diagnosis, antibiotic treatment was started and the fracture was reduced and fixed.The literature on this entity is sparse and most of the management protocols are based on its hand equivalent—the Seymour fracture, emphasising the low threshold for treating these lesions as an open fracture.

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“…1,[4][5][6][8][9][10] Stubbed toe injury involves an open fracture of the distal phalanx base and is comparable to finger nail bed injury caused by a hyperflexion-like mechanism. 3,4 But, this injury is usually not associated with the IPJ.…”

mentioning

confidence: 98%