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Complete Traumatic Separation of Proximal Femoral Epiphysis in A 2 Year Old Child
Chandra Prakash Pal1, Deepak Kumar1, Pulkesh Singh2
1Department of orthopaedics, S. N. Medical College, Agra, India.
Insights
Proximal femoral epiphyseal separation is a rare pediatric hip injury. This case report details successful surgical fusion and early ambulation in a 2-year-old, offering hope for similar traumatic cases.
Area of Science:
- Pediatric Orthopedics
- Traumatology
Background:
- Hip fractures are common in adults but rare in children.
- Proximal femoral epiphyseal separation can occur with traumatic hip dislocation in children with open epiphyses.
- Prognosis for proximal femoral epiphyseal separation is generally poor due to osteonecrosis risk.
Observation:
- A case of complete proximal femoral epiphyseal separation in a 2-year-old female child is presented.
- The child underwent open reduction and internal fixation with a single K-wire.
- Postoperative follow-up showed fusion of the proximal femoral epiphysis at 3 months.
Findings:
- The surgical intervention resulted in fusion of the proximal femoral epiphysis to the femoral neck within 3 months.
- At 8 months post-surgery, the child could stand and walk independently.
- Long-term outcomes are pending further observation.
Implications:
- This case suggests that surgical intervention may lead to favorable outcomes in traumatic proximal femoral epiphyseal separation.
- Early fusion and functional recovery indicate potential for improved prognosis in this rare injury.
- Further long-term studies are needed to confirm the durability and success of this treatment approach.
Introduction:
Hip fractures are very common in adults, but are rare in children, comprising less than 1% of all pediatric fractures. Separation of the proximal femoral epiphysis can occur in a child with a traumatic hip dislocation and an open epiphysis. Regardless of the mechanism of proximal femoral epiphyseal separation, the prognosis is poor secondary to the development of osteonecrosis.
Case Report:
Here we are reporting a case of complete separation of the proximal epiphysis of the femur in a 2 year old female child. She was treated by open reduction and internal fixation by a single k-wire of proximal femoral epiphysis. Regular follow up showed fusion of proximal femoral epiphysis at about 3 months of post operative period. After 8 months of follow up she can stand and walk without support. Long term outcome is awaited.
Conclusion:
Traumatic separation of the proximal femoral epiphysis is a rare but devastating injury because osteonecrosis occurs in most cases. In our study we found fusion of the proximal femoral epiphysis to the neck after 3 months of postoperative period. But to comment upon the final outcome a long follow up is awaited.