Baseball Injury Resulting in Type III Salter-Harris Fracture of the First Proximal Phalangeal Base: A Case Report.

OBJECTIVE: The purpose of this report is to describe the clinical, radiographic, and diagnostic ultrasound findings in a patient who sustained a type III Salter-Harris fracture of the first proximal phalanx.

CLINICAL FEATURES: A 14-year-old male baseball player presented to a chiropractic clinic with a 2-day history of proximal thumb pain, which began following a forceful hyperabduction injury while sliding into base. Thenar swelling was evident on clinical examination, and both active and passive thumb motions were painful in all directions. Radiography revealed a type III Salter-Harris fracture of the first proximal phalangeal base. Additionally, diagnostic ultrasonography demonstrated a probable high-grade ulnar collateral ligament sprain. No further displacement of the fracture fragment was visualized with radial deviation stress.

INTERVENTION AND OUTCOME: The patient was referred to a pediatric hand orthopedic specialist for consultation and treatment.

CONCLUSION: Salter-Harris III fractures of the thumb base warrant special attention to various clinical and imaging features, which may affect patient outcomes. Fracture characterization with radiography is essential in determining the proper management. Ultrasonography and magnetic resonance imaging may be useful in the evaluation of concomitant soft tissue injuries, as demonstrated in this case report.