Digital Physeal Arrest Following Dactylitis in a Child

• Published in: Journal of orthopaedic case reports Vol. 13; no. 10; pp. 137 - 140
• Main Authors: Ow, Nadya Liyana, Nottage, Matthew, Bale, Peter, Buddhdev, Pranai
• Format: Report
• Language: English
• Published: 01.10.2023
• ISSN: 2250-0685
• DOI: 10.13107/jocr.2023.v13.i10.3966

IntroductionFollowing trauma, premature growth arrest is a common outcome when the injury affects the pediatric growth plate. Dactylitis describes global inflammation affecting one or more digits in the hand or foot. It occurs in various seronegative arthropathies and septic arthritis. Physeal fusion following dactylitis is uncommon and is not described in the current literature.Case ReportWe report the case of a 12-year-old boy, whose minor non-penetrating injury resulted in circumferential edema of his left third upper limb digit, typical of dactylitis. No evidence of infection was found during clinical examination or blood work. Significant stiffness of the digit remained over the course of a few months with spontaneous resolution following functional hand therapy. The child presented to pediatric orthopedics with cessation of longitudinal growth. Evidence of premature physeal fusion of the involved phalanges was confirmed on radiographs.ConclusionGrowth arrest following dactylitis has not previously been reported. Clinicians managing this condition should be aware of this rare complication. We recommend that inflammation is treated promptly, and patients are monitored clinically and radiologically to address any potential functional deficit.