• Pediatric emergency care · Mar 2004

    Review Case Reports

    Child abuse in infants with proximal physeal injuries of the femur.

    • Joshua C W Jones, Kenneth W Feldman, and James D Bruckner.
    • *General Pediatric Division, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA; †Department of Orthopedics, University of Washington School of Medicine, Seattle, WA; ‡Children's Hospital and Regional Medical Center, Seattle, WA.
    • Pediatr Emerg Care. 2004 Mar 1; 20 (3): 157-161.

    ObjectiveChild abuse has been recognized to be a common cause of femur fractures in infants. Fractures of the proximal femoral physis in abused infants have been less emphasized. Our report seeks to highlight this infrequent but clinically important inflicted injury.MethodsReport of 2 cases and a literature review of fractures of the proximal femoral physis in infants, including the role of abuse in this injury.ConclusionProximal femoral physeal injuries occur infrequently in infants but often result from abuse. Diagnosis may be difficult due to lack of femoral head ossification before 4 months of age and clinical findings suggesting developmental dysplasia of the hip. Current imaging modalities can differentiate physeal injuries from developmental dysplasia of the hip. Early recognition and treatment can minimize sequelae.

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