Traumatic separation of the upper femoral epiphysis in a neonate

Abstract

Background: Traumatic separation of the upper femoral epiphyses at birth is a rare event. Other terminologies that have been used to describe the injury include traumatic proximal femoral epiphysiolysis and apparent dislocation of the hip. This injury is associated with difficult deliveries.

Aim: To report a case of traumatic separation of the upper femoral epiphysis in a neonate following a caesarean section.

Case Report: A full term infant female was delivered by breech extraction through a caesarean section in 2007. She weighed 4.2kg at birth and her mother was not a known diabetic. Her mother noticed she had reduced movement in her right lower extremity five days after delivery and this necessitated an orthopaedic consultation. After a clinical review a diagnosis of congenital dislocation of the right hip was made.An initial pelvic radiograph was taken and a repeat radiograph taken 3 weeks after delivery showed callus around the neck of the right femur. This indicated a healing traumatic separation of the right upper femoral epiphysis.

Conclusion: Traumatic separation of the upper femoral epiphysis in the newborn is an uncommon injury. A high index of suspicion is required as the condition is easily misdiagnosed.

Keywords: Trauma; Epihysiolysis; Proximal femur; Neonate; Caesarean section