Does K-wire fixation improve outcomes in children with a Seymour fracture?

Abstract

IntroductionThe Seymour fracture is a juxta-epiphyseal fracture of the terminal phalanx of the finger. Sources vary on the recommended management, with some advocating treatment without K-wires to avoid metalwork-associated infection, and others suggesting that K-wire fixation is necessary due to the risks of fracture re-displacement. MethodsA best evidence topic in paediatric hand surgery was written according to a structured protocol. Searches were performed on December 28, 2021 in Cochrane library and PubMed. Results69 papers were found using the reported search strategy, and eight papers representing the best evidence to answer this question are discussed. DiscussionThe evidence on this subject is suboptimal as five of these studies were case-series that do not make direct comparisons between the question's intervention and control groups, and the other three were single-centre retrospective cohort studies with no randomisation. ConclusionThe best evidence topic concludes that K-wire fixation appears to be associated with a higher rate of physeal disturbance and lower rates of infection, fracture re-displacement, and flexion deformity.