Child abuse in infants with proximal physeal injuries of the femur

Pediatr Emerg Care. 2004 Mar;20(3):157-161. doi: 10.1097/01.pec.0000117923.65522.6f.

Abstract

Objective: Child 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.

Methods: Report of 2 cases and a literature review of fractures of the proximal femoral physis in infants, including the role of abuse in this injury.

Conclusion: Proximal 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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Age Factors
  • Child Abuse / diagnosis*
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Femoral Fractures / diagnosis
  • Femoral Fractures / diagnostic imaging
  • Femoral Fractures / etiology
  • Femur / diagnostic imaging
  • Femur / injuries*
  • Femur Head / diagnostic imaging
  • Femur Head / injuries
  • Femur Head Necrosis / etiology
  • Foster Home Care
  • Fractures, Bone / diagnostic imaging
  • Hip Dislocation / diagnosis
  • Hip Dislocation / diagnostic imaging
  • Hip Dislocation / etiology
  • Hip Dislocation, Congenital / diagnosis
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Multiple Trauma / diagnostic imaging
  • Neonatal Abstinence Syndrome / complications
  • Osteogenesis
  • Radiography
  • Salter-Harris Fractures