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Complete distal humeral epiphyseal separation indicating a battered child syndrome: a case report
Matthias Hansen1, A Weltzien, J Blum
1Clinic for Trauma-, Hand- and Reconstructive Surgery, City Hospital Worms, Gabriel-von-Seidl-Strasse 81, Worms, Germany. hansen-mainz@gmx.de
Insights
Complete distal humeral epiphysiolysis, a rare elbow injury, is often linked to child abuse. Early diagnosis and surgical intervention are crucial for optimal outcomes, though growth disturbances may occur.
Area of Science:
- Pediatric Orthopedics
- Traumatology
Background:
- Complete distal humeral epiphysiolysis is an uncommon injury, frequently associated with severe trauma like birth injuries or battered child syndrome.
- Accurate diagnosis can be challenging, with potential misinterpretation as elbow dislocation.
Observation:
- A case report details a 5-month-old female with distal humeral epiphysiolysis, diagnosed with battered child syndrome.
- Treatment involved open reduction and temporary transfixation of the distal humeral physis.
Findings:
- Post-treatment, the elbow function was nearly normal after 1.5 years.
- A growth disturbance in the ulnar condyle resulted in 10 degrees of cubitus varus.
Implications:
- Distal humeral epiphysiolysis is a significant indicator of child abuse.
- Prompt diagnosis and appropriate surgical management are essential, alongside awareness of potential long-term growth complications.
Background:
Complete distal humeral epiphysiolysis is a rare and uncommon injury and may result from severe trauma, e.g. birth injury or battered child syndrome.
Case Report:
This is a case report of a 5-month-old female child with distal humeral epiphysiolysis. In the course of clinical and radiological examinations, a battered child syndrome could be diagnosed. Open reduction and temporary transfixation of the distal humeral physis were performed. In the middle term follow-up, 1.5-years after the injury, the function of the elbow was nearly normal but the ulnar condyle showed growth disturbance with cubitus varus of 10 degrees.
Conclusion:
Correct diagnosis of complete distal humeral epiphysiolysis may be difficult and misinterpretation of the injury as elbow dislocation should be avoided. This particular lesion is a strong indicator of child abuse. Treatment options and the necessity of operative procedures are discussed.
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